Safety of Fertility-Sparing Surgery in Primary Mucinous Carcinoma of the Ovary
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Purpose The aim of this study is to evaluate the safety of fertility-sparing surgery as the treatmentfor patients with primary mucinous epithelial ovarian cancer. Materials and MethodsA retrospective study of patients with mucinous ovarian cancer between 1991 and 2010was performed. The demographics and survival outcomes were compared between patientswho underwent fertility-sparing surgery and those who underwent radical surgery. ResultsA total of 110 patients underwent primary surgery. At the time of surgery, tumors appearedto be grossly confined to the ovaries in 90 patients, and evidence of metastasis was definitein 20 patients. Of the 90 patients with tumors that appeared to be grossly confined to theovaries at surgical exploration, 35 (38.9%) underwent fertility-sparing surgery. The Kaplan-Meier curve and the log rank test showed no difference in either recurrence-free survival(p=0.792) or disease-specific survival (p=0.706) between the two groups. Furthermore,there was no significant difference in recurrence-free survival (p=0.126) or disease-specificsurvival (p=0.377) between the two groups, even when the analysis was limited to womenbelow the age of 40. In a multivariate Cox model, fertility-sparing surgery had no effect oneither recurrence-free survival (recurrence hazard ratio [HR], 1.20; 95% confidence interval[CI], 0.25 to 5.71) or disease-specific survival (death HR, 0.88; 95% CI, 0.17 to 4.60). ConclusionFertility-sparing surgery in primary mucinous cancer grossly confined to the ovaries may bea safe option and one not associated with an increase in recurrence or mortality.
Abstract
Purpose The aim of this study is to evaluate the safety of fertility-sparing surgery as the treatmentfor patients with primary mucinous epithelial ovarian cancer. Materials and MethodsA retrospective study of patients with mucinous ovarian cancer between 1991 and 2010was performed. The demographics and survival outcomes were compared between patientswho underwent fertility-sparing surgery and those who underwent radical surgery. ResultsA total of 110 patients underwent primary surgery. At the time of surgery, tumors appearedto be grossly confined to the ovaries in 90 patients, and evidence of metastasis was definitein 20 patients. Of the 90 patients with tumors that appeared to be grossly confined to theovaries at surgical exploration, 35 (38.9%) underwent fertility-sparing surgery. The Kaplan-Meier curve and the log rank test showed no difference in either recurrence-free survival(p=0.792) or disease-specific survival (p=0.706) between the two groups. Furthermore,there was no significant difference in recurrence-free survival (p=0.126) or disease-specificsurvival (p=0.377) between the two groups, even when the analysis was limited to womenbelow the age of 40. In a multivariate Cox model, fertility-sparing surgery had no effect oneither recurrence-free survival (recurrence hazard ratio [HR], 1.20; 95% confidence interval[CI], 0.25 to 5.71) or disease-specific survival (death HR, 0.88; 95% CI, 0.17 to 4.60). ConclusionFertility-sparing surgery in primary mucinous cancer grossly confined to the ovaries may bea safe option and one not associated with an increase in recurrence or mortality.
참고문헌 (25)
- Young RC, "Staging laparotomy in early ovarian cancer", JAMA, 250, pp.3072~3076 (1983)
- Heintz AP, "Carcinoma of the ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer", Int J Gynaecol Obstet, 95(Suppl 1), pp.S161~192 (2006)
- Borgfeldt C, "Fertility-sparing surgery and outcome in fertile women with ovarian borderline tumors and epithelial invasive ovarian cancer", Eur J Obstet Gynecol Reprod Biol, 134, pp.110~114 (2007)
- Fruscio R, "Conservative management of early-stage epithelial ovarian cancer : results of a large retrospective series", Ann Oncol, 24, pp.138~144 (2013)
- Kajiyama H, "Fertility-sparing surgery in young women with mucinous adenocarcinoma of the ovary", Gynecol Oncol, 122, pp.334~338 (2011)
- Yong-Soon Kwon, "Fertility preservation in patients with early epithelial ovarian cancer", Journal of Gynecologic Oncology, 20(1), pp.44~47 (2009), 대한부인종양학회
- Morice P, "Conservative treatment in epithelial ovarian cancer : results of a multicentre study of the GCCLCC(Groupe des Chirurgiens de Centre de Lutte Contre le Cancer)and SFOG(Societe Francaise d'Oncologie Gynecologique)", Hum Reprod, 20, pp.1379~1385 (2005)
- Park JY, "Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer : oncologic safety and reproductive outcomes", Gynecol Oncol, 110, pp.345~353 (2008)
- Satoh T, "Outcomes of fertility-sparing surgery for stage I epithelial ovarian cancer : a proposal for patient selection", J Clin Oncol, 28, pp.1727~1732 (2010)
- Schilder JM, "Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy", Gynecol Oncol, 87, pp.1~7 (2002)
- Zanetta G, "Conservative surgery for stage I ovarian carcinoma in women of childbearing age", Br J Obstet Gynaecol, 104, pp.1030~1035 (1997)
- "Ovarian cancer clinical practice guidelines in oncology (v.I.2010)" (2010)[URL]
- McGuire V, "Survival among U.S. women with invasive epithelial ovarian cancer", Gynecol Oncol, 84, pp.399~403 (2002)
- Hess V, "Mucinous epithelial ovarian cancer : a separate entity requiring specific treatment", J Clin Oncol, 22, pp.1040~1044 (2004)
- Mizuno M, "Long-term prognosis of stage I ovarian carcinoma. Prognostic importance of intraoperative rupture", Oncology, 65, pp.29~36 (2003)
- Cho YH, "Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors?", Gynecol Oncol, 103, pp.878~882 (2006)
- Schmeler KM, "Prevalence of lymph node metastasis in primary mucinous carcinoma of the ovary", Obstet Gynecol, 116(2 Pt 1), pp.269~273 (2010)
- Kajiyama H, "Long-term survival of young women receiving fertility-sparing surgery for ovarian cancer in comparison with those undergoing radical surgery", Br J Cancer, 105, pp.1288~1294 (2011)
- Vergote I, "Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma", Lancet, 357, pp.176~182 (2001)
- Menczer J., "Conservative fertility-sparing surgical treatment of invasive epithelial ovarian cancer: when is it acceptable?", Isr Med Assoc J, 15, pp.116~120 (2013)
- Raspagliesi F, "Conservative surgery in high-risk epithelial ovarian carcinoma", J Am Coll Surg, 185, pp.457~460 (1997)
- Kurman RJ, "The origin and pathogenesis of epithelial ovarian cancer : a proposed unifying theory", Am J Surg Pathol, 34, pp.433~443 (2010)
- Harrison ML, "Mucinous ovarian cancer", Int J Gynecol Cancer, 18, pp.209~214 (2008)
- Emine Karabuk, "Comparison of advanced stage mucinous epithelial ovarian cancer and serous epithelial ovarian cancer with regard to chemosensitivity and survival outcome: a matched case-control study", Journal of Gynecologic Oncology, 24(2), pp.160~166 (2013), 대한부인종양학회
- Benjamin I, "Occult bilateral involvement in stage I epithelial ovarian cancer", Gynecol Oncol, 72, pp.288~291 (1999)