Laparoscopic fertility-sparing surgery for early ovarian epithelial cancer: A multi-institutional experience

abstract

Highlights

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Laparoscopic fertility-sparing treatment of early ovarian cancer shows encouraging survival outcomes.

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After conservative treatment, 64.8% woman reported pregnancy intent and 60% of these conceived spontaneously.

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Objective

There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to investigate the safety, adequacy and fertility outcome of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging using a multi-institutional sample.

Methods

Prospectively collected data in five gynecologic oncology service databases were searched for epithelial EOC patients undergoing laparoscopic fertility-preserving surgery. Surgical, pathologic, oncologic and reproductive outcome data were analysed.

Results

The study cohort consisted of 65 women. Median age of the patients was 33 (range: 21–42) years. In this cohort 36 (55.4%) and 29 (44.6%) patients were at low risk (FIGO stage IA G1–2) and high-risk (FIGO stage IA G3 or more), respectively. The disease was reclassified to a higher stage in 4 (6.1%) women. After a median follow up period of 38 months (range: 2–144), the overall survival was 95.4% and recurrence-free survival 84.6%. Overall, there were 23 pregnancies in 22 women. After ovarian cancer treatment, 64.8% women reported pregnancy intent and 60% of these conceived spontaneously.

Conclusions

Laparoscopic staging may represent a viable option for premenopausal women seeking fertility preservation in the setting of early ovarian cancer. More research is needed to determine whether laparoscopy may offer reproductive benefits to this particular population.