TY - JOUR
T1 - Safety of ovarian conservation and fertility preservation in advanced borderline ovarian tumors
AU - Aviel-Ronen, Sarit
AU - Perri, Tamar
AU - Hogen, Liat
AU - Jakobson-Setton, Ariella
AU - Ben-Baruch, Gilad
AU - Korach, Jacob
N1 - Publisher Copyright: © 2015 American Society for Reproductive Medicine.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Objective To assess the impact of a fertility-sparing approach on disease recurrence in women with advanced borderline ovarian tumors. Design Historic cohort study. Setting A tertiary referral center for gynecological oncology patients and a university teaching hospital. Patient(s) Consecutive patients with advanced borderline ovarian tumors defined as stage IC and above, treated at a single institution during a span of 30 years. Intervention(s) Data on surgical approach (e.g., fertility sparing, ovarian conserving) as well as histopathology, disease stage, CA-125 level, and use of chemotherapy were collected from the medical records, and their impact on disease recurrence was assessed. Main Outcome Measure(s) Recurrence-free interval. Its association with the type of surgery and with other clinical and pathological features was assessed using the Kaplan Meier and Cox proportional hazards methods. Result(s) Fifty-nine patients with advanced disease were identified. Median follow-up was 55.3 months. Mean age at diagnosis was 35 years. Most of the tumors (51, 84.4%) had serous histology. Twenty-seven patients (45.8%) developed recurrences and 6 (10%) died of their disease. Mean time to recurrence was 30.6 months. Of 44 women ≤40 years, 33 (75%) had a fertility-sparing procedure. Fertility preservation was not associated with disease recurrence. A total of 34 pregnancies and 26 live births were documented among 21 patients attempting conception. Conclusion(s) Borderline ovarian tumors carry a favorable prognosis, even at an advanced stage. Fertility preservation was not found to be associated with an increased risk of relapse in young patients with advanced disease, and may be reasonably considered.
AB - Objective To assess the impact of a fertility-sparing approach on disease recurrence in women with advanced borderline ovarian tumors. Design Historic cohort study. Setting A tertiary referral center for gynecological oncology patients and a university teaching hospital. Patient(s) Consecutive patients with advanced borderline ovarian tumors defined as stage IC and above, treated at a single institution during a span of 30 years. Intervention(s) Data on surgical approach (e.g., fertility sparing, ovarian conserving) as well as histopathology, disease stage, CA-125 level, and use of chemotherapy were collected from the medical records, and their impact on disease recurrence was assessed. Main Outcome Measure(s) Recurrence-free interval. Its association with the type of surgery and with other clinical and pathological features was assessed using the Kaplan Meier and Cox proportional hazards methods. Result(s) Fifty-nine patients with advanced disease were identified. Median follow-up was 55.3 months. Mean age at diagnosis was 35 years. Most of the tumors (51, 84.4%) had serous histology. Twenty-seven patients (45.8%) developed recurrences and 6 (10%) died of their disease. Mean time to recurrence was 30.6 months. Of 44 women ≤40 years, 33 (75%) had a fertility-sparing procedure. Fertility preservation was not associated with disease recurrence. A total of 34 pregnancies and 26 live births were documented among 21 patients attempting conception. Conclusion(s) Borderline ovarian tumors carry a favorable prognosis, even at an advanced stage. Fertility preservation was not found to be associated with an increased risk of relapse in young patients with advanced disease, and may be reasonably considered.
KW - Borderline ovarian tumor
KW - fertility preservation
KW - ovarian conservation
UR - http://www.scopus.com/inward/record.url?scp=84943411335&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.fertnstert.2015.03.038
DO - https://doi.org/10.1016/j.fertnstert.2015.03.038
M3 - مقالة
C2 - 25956371
SN - 0015-0282
VL - 104
SP - 138
EP - 144
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 1
ER -