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Fertility preservation in young women with epithelial ovarian cancer
Article first published online: 10 AUG 2009
Copyright © 2009 American Cancer Society
Volume 115, Issue 18, pages 4118–4126, 15 September 2009
How to Cite
Wright, J. D., Shah, M., Mathew, L., Burke, W. M., Culhane, J., Goldman, N., Schiff, P. B. and Herzog, T. J. (2009), Fertility preservation in young women with epithelial ovarian cancer. Cancer, 115: 4118–4126. doi: 10.1002/cncr.24461
- Issue published online: 4 SEP 2009
- Article first published online: 10 AUG 2009
- Manuscript Accepted: 18 DEC 2008
- Manuscript Revised: 14 DEC 2008
- Manuscript Received: 21 OCT 2008
- ovarian cancer;
- fertility-conserving surgery
Surgical management of ovarian cancer consists of hysterectomy with bilateral oophorectomy. In young women, this results in the loss of reproductive function and estrogen deprivation. In the current study, the authors examined the safety of fertility-conserving surgery in premenopausal women with epithelial ovarian cancers.
Women aged ≤50 years with stage IA or IC epithelial ovarian cancer who were registered in the Surveillance, Epidemiology, and End Results database were examined. Patients who underwent bilateral oophorectomy were compared with those who underwent ovarian conservation. A second analysis examined uterine conservation versus hysterectomy. Multivariate Poisson regression models were developed to describe predictors of fertility preservation. Survival was examined using Cox proportional hazards models and the Kaplan-Meier method.
In total, 1186 women, including 754 women (64%) who underwent bilateral oophorectomy and 432 women (36%) who underwent ovarian preservation, were identified. Younger age, later year of diagnosis, and residence in the eastern or western United States were associated with ovarian preservation (P < .05 for all). Women with endometrioid and clear cell histologies and stage IC disease were less likely to have ovarian conservation (P < .05). In a Cox model, ovarian preservation had no effect on survival (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.39-1.20). Young age, later year of diagnosis, residence in the eastern or western United States, single women, mucinous tumors, and patients with stage IA disease were more likely to have uterine preservation (P < .05 for all). In a multivariate model, uterine preservation had no effect on survival (HR, 0.87; 95% CI, 0.62-1.22).
Ovarian and uterine-conserving surgery were safe in young women who had stage IA and IC epithelial ovarian cancer. Cancer 2009. © 2009 American Cancer Society.