TITLE:
Role of Ovarian Fertility Sparing Surgery (FSS) in Cases of Early Stage 1 Ovarian Cancer in Patients in Reproductive Age Group
AUTHORS:
Ahmed Essmat
KEYWORDS:
Early Ovarian Cancer, Fertility Sparing Surgery, Fertility Preservation
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.6,
June
18,
2021
ABSTRACT: Objective: To assess the role of FSS in women with early stage 1 ovarian cancer. Methods: This was a retrospective analytic study of the results of treatment of 24
patients all under 40 years of age who underwent a full conservative staging
laparotomy procedure in oncology center of El Shatby Maternity hospital,
Alexandria University in the period of one year from October 2019 to September
2020. All patients were followed up for a six month period following surgery by
the pre-operatively elevated tumor marker and by a CT abdomen and pelvis to
detect any tumor recurrence. Results: The mean age at diagnosis was 24.29 Years. 6/24 (25%) of surface
epithelial tumor were G1, 8/24 (33.3%) were G2, 4/24 (16.7%) were G3. 20/24 (83.3%)
of patients were stage FIGO 1a, 4/25 (16.7%)
were stage 1b, and none of them was stage 1c. 20/24 (83.3%)
of patients were stage FIGO 1a, 4/25 (16.7%)
were stage 1b, and none of them was stage 1c. Recurrence was reported in 3/24
of cases (12.5%), such 3 cases underwent unilateral SO plus a FCSLP. No
recurrence was reported in cases of bilateral tumors that underwent unilateral
SO and a contralateral cystectomy. 100% of recurrence was in epithelial tumors.
1/24 (4.1%) was clear cell, 1/24 (4.1%) was serous and 1/24 (4.1%) was
mucinous. None of the endometroid tumors did recur. Also none of the
non-epithelial tumors showed any recurrence. Tumors of G1 showed no recurrence,
G2 tumors showed 33.3% recurrence and G3 tumors showed the highest recurrence
rate (66.6%). Conclusion: ovarian FSS is a safe surgical option for nearly all OC patients with
low risk of recurrence, with apparently early stage OC, after being confirmed
by a FCSLP to exclude any occult metastasis (occult advanced stage OC),
including those cases of early epithelial OC, germ cell and gonadal stromal
tumors and it should be considered for patients who have a strong desire to
keep their fertility.