abstract
Long-term follow-up of patients with an isolated ovarian recurrence
after conservative treatment of epithelial ovarian cancer: review of the
results of a international multicenter study comprising 545 patients
OBJECTIVE:
To
determine the long-term outcomes of patients with an
isolated ovarian
recurrence after fertility sparing surgery (FSS) for epithelial ovarian
cancer (EOC) and to evaluate the recurrence rates (and location)
according to the new 2014 International Federation of Gynecology and
Obstetrics (FIGO) staging system.
DESIGN:
Retrospective multicenter study.
SETTING:
Teams having reported recurrence after FSS for EOC.
PATIENT(S):
Four series comprising 545 patients undergoing FSS and 63 (12%) recurrences.
INTERVENTION(S):
FSS (salpingo-oophorectomy for a majority of cases) for EOC.
MAIN OUTCOMES MEASURE(S):
Recurrences rates and characteristics of recurrent disease.
RESULT(S):
Among
63 recurrent patients, 24 (38%) recurrences were isolated on the spared
ovary, and 39 (62%) arose at an extraovarian site. Among the patients
with an isolated ovarian recurrence, three patients died after a median
follow-up period of 186 months (range: 28-294 months). Among the
patients with recurrent extraovarian disease, 24 died and 7 were alive
with persistent disease after a median follow-up period of 34 months
(range: 3-231 months). The overall rate of isolated ovarian and
extrapelvic recurrences was higher for grade 3 tumors (compared with
grades 1/2).
CONCLUSION(S):
The
long-term survival of patients with an isolated ovarian recurrence
after FSS for EOC remains favorable. The prognosis of patients with an
extraovarian recurrence is poor compared with those who have an isolated
recurrent ovarian tumor. Grade 3 tumors (compared to grades 1/2) give
rise to a higher rate of extraovarian recurrences.
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