Top

Journal of Ovarian Research

Published in:

Open Access 01-12-2014 | Research

Laparoscopic fertility-sparing surgery for early stage ovarian cancer: a single-centre case series and systematic literature review

Authors: Antonella Cromi, Giorgio Bogani, Stefano Uccella, Jvan Casarin, Maurizio Serati, Fabio Ghezzi

Published in: Journal of Ovarian Research | Issue 1/2014

Abstract

Background

There is as yet limited evidence about fertility-sparing surgery for early ovarian cancer (EOC) carried out laparoscopically. We sought to analyze recurrence patterns and fertility outcome in a cohort of ovarian cancer patients who underwent fertility-saving laparoscopic surgical staging.

Methods

We conducted a retrospective analysis of prospectively collected data on all patients undergoing fertility-sparing laparoscopic staging procedures for presumed EOC at a single gynecologic oncology service. Oncologic safety and reproductive outcome were the main outcome measures. The pertinent literature is reviewed.

Results

The study cohort consisted of 12 women. Cases included 5 invasive epithelial tumors and 7 nonepithelial tumors. The disease was reclassified to a higher stage in one woman. After a median follow up period of 38 months (range: 14–108), the overall survival was 100% and recurrence-free survival 90.9%. Five (100%) of patients who attempted pregnancy conceived spontaneously. Three of them had uneventful term pregnancy delivering healthy babies. The literature search yielded 62 cases of laparoscopic fertility conserving surgery for ovarian cancer. There were 4 (6.2%) recurrences. Cumulative pregnancy and live birth rate were not estimable as earlier publications lack essential data.

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.

Available only for authorised users

Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA: SEER cancer statistics review, 1975–2010 , national cancer institute. Bethesda, MD. based on November 2012 SEER data submission, posted to the SEER web site, 2013 [http://seer.cancer.gov/csr/1975_2010/]

National Collaborating Centre for Cancer (UK): Ovarian cancer. The recognition and initial management of ovarian cancer. NICE Clinical Guidelines, No. 122 2011, 2–4. Cardiff (UK)

Duska LR, Chang Y, Flynn CE, Chen AH, Goodman A, Fuller AF, Nikrui N: Epithelial ovarian carcinoma in the reproductive age group. Cancer 1999, 85: 2623–2629. 10.1002/(SICI)1097-0142(19990615)85:12<2623::AID-CNCR19>3.0.CO;2-OCrossRefPubMed

Zapardiel I, Diestro MD, Aletti G: Conservative treatment of early stage ovarian cancer: oncological and fertility outcomes. Eur J Surg Oncol 2014, 40: 387–393. 10.1016/j.ejso.2013.11.028CrossRefPubMed

du Bois A, Heitz F, Harter P: Fertility-sparing surgery in ovarian cancer: a systematic review. Onkologie 2013, 36: 436–443.CrossRefPubMed

Nam JH, Park JY: Fertility-sparing surgery for young women with early-stage epithelial ovarian cancer. Gynecol Obstet Invest 2013, 76: 14–24.PubMed

Leblanc E, Querleu D, Narducci F, Occelli B, Papageorgiou T, Sonoda Y: Laparoscopic staging of early stage invasive adnexal tumors: a 10-year experience. Gynecol Oncol 2004, 94: 624–629. 10.1016/j.ygyno.2004.05.052CrossRefPubMed

Colomer AT, Jiménez AM, Bover Barceló MI: Laparoscopic treatment and staging of early ovarian cancer. J Minim Invasive Gynecol 2008, 15: 414–419. 10.1016/j.jmig.2008.04.002CrossRefPubMed

Muzii L, Palaia I, Sansone M, Calcagno M, Plotti F, Angioli R, Panici PB: Laparoscopic fertility-sparing staging in unexpected early stage ovarian malignancies. Fertil Steril 2009, 91: 2632–2637. 10.1016/j.fertnstert.2008.03.058CrossRefPubMed

10.

Nezhat FR, Ezzati M, Chuang L, Shamshirsaz AA, Rahaman J, Gretz H: Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome. Am J Obstet Gynecol 2009, 200: 83. e1–6PubMed

11.

Cheng X, Cheng B, Wan X, Lu W, Xie X: Outcomes of conservative surgery in early epithelial ovarian carcinoma. Eur J Gynaecol Oncol 2012, 33: 93–95.CrossRefPubMed

12.

Brockbank EC, Harry V, Kolomainen D, Mukhopadhyay D, Sohaib A, Bridges JE, Nobbenhuis MA, Shepherd JH, Ind TE, Barton DP: Laparoscopic staging for apparent early stage ovarian or fallopian tube cancer. First case series from a UK cancer centre and systematic literature review. Eur J Surg Oncol 2013, 39: 912–917. 10.1016/j.ejso.2013.05.007CrossRefPubMed

13.

National Comprehensive Cancer Network (NCCN): Ovarian cancer guidelines. Version 2.2011. . Accessed October 30, 2013 http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

14.

Mabrouk M, Frumovitz M, Greer M, Sharma S, Schmeler KM, Soliman PT, Ramirez PT: Trends in laparoscopic and robotic surgery among gynecologic oncologists: a survey update. Gynecol Oncol 2009, 112: 501–505. 10.1016/j.ygyno.2008.11.037PubMedCentralCrossRefPubMed

15.

Pike NA, Evangelista LS, Doering LV, Eastwood JA, Lewis AB, Child JS: Sex and age differences in body-image, self-esteem, and body mass index in adolescents and adults after single-ventricle palliation. Pediatr Cardiol 2012, 33: 705–712. 10.1007/s00246-012-0198-7PubMedCentralCrossRefPubMed

16.

Minig L, Vélez JI, Trimble EL, Biffi R, Maggioni A, Jeffery DD: Changes in short-term health-related quality of life in women undergoing gynecologic oncologic laparotomy: an associated factor analysis. Support Care Cancer 2013, 21: 715–726. 10.1007/s00520-012-1571-zCrossRefPubMed

17.

Ghezzi F, Malzoni M, Vizza E, Cromi A, Perone C, Corrado G, Uccella S, Cosentino F, Mancini E, Franchi M: Laparoscopic staging of early ovarian cancer: results of a multi-institutional cohort study. Ann Surg Oncol 2012, 19: 1589–1594. 10.1245/s10434-011-2138-9CrossRefPubMed

18.

Tozzi R, Köhler C, Ferrara A, Schneider A: Laparoscopic treatment of early ovarian cancer: surgical and survival outcomes. Gynecol Oncol 2004, 93: 199–203. 10.1016/j.ygyno.2004.01.004CrossRefPubMed

19.

Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH: Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer. Ann Surg Oncol 2008, 15: 2012–2019. 10.1245/s10434-008-9893-2CrossRefPubMed

20.

Jung US, Lee JH, Kyung MS, Choi JS: Feasibility and efficacy of laparoscopic management of ovarian cancer. J Obstet Gynaecol Res 2009, 35: 113–118. 10.1111/j.1447-0756.2008.00830.xCrossRefPubMed

21.

Hu J, Zhu LR, Liang ZQ, Meng YG, Guo HY, Qu PP, Ma CL, Xu CJ, Yuan BB: Clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma. J Zhejiang Univ Sci B 2011, 12: 787–795.PubMedCentralCrossRefPubMed

22.

Schreuder HW, Pattij TO, Zweemer RP, van Baal MW, Verheijen RH: Increasing experience in laparoscopic staging of early ovarian cancer. Gynecol Surg 2012, 9: 89–96. 10.1007/s10397-011-0692-6PubMedCentralCrossRefPubMed

23.

Ghezzi F, Cromi A, Siesto G, Serati M, Zaffaroni E, Bolis P: Laparoscopy staging of early ovarian cancer: our experience and review of the literature. Int J Gynecol Cancer 2009, 19: S7-S13. 10.1111/IGC.0b013e3181bf82f3CrossRefPubMed

24.

Ovarian cancer survival statistics . Accessed on 30 October 2013 http://www.cancerresearchuk.org/cancer-info/cancerstats/types/ovary/survival/#One

25.

Benjamin I, Morgan MA, Rubin SC: Occult bilateral involvement in stage I epithelial ovarian cancer. Gynecol Oncol 1999, 72: 288–291. 10.1006/gyno.1998.5260CrossRefPubMed

26.

Schlaerth AC, Chi DS, Poynor EA, Barakat RR, Brown CL: Long-term survival after fertility-sparing surgery for epithelial ovarian cancer. Int J Gynecol Cancer 2009, 19: 1199–1204. 10.1111/IGC.0b013e31819d82c3CrossRefPubMed

27.

Colombo N, Chiari S, Maggioni A, Bocciolone L, Torri V, Mangioni C: Controversial issues in the management of early epithelial ovarian cancer: conservative surgery and role of adjuvant therapy. Gynecol Oncol 1994, 55: S47-S51. 10.1006/gyno.1994.1341CrossRefPubMed

28.

Petrillo M, Legge F, Ferrandina G, Monterisi A, Pedone Anchora L, Scambia G: Fertility-sparing surgery in ovarian cancer extended beyond the ovaries: a case report and review of the literature. Gynecol Obstet Invest 2014, 77: 1–5. 10.1159/000353277CrossRefPubMed

29.

Morice P, Leblanc E, Rey A, Baron M, Querleu D, Blanchot J, Duvillard P, Lhommé C, Castaigne D, Classe JM, Bonnier P, GCCLCC and SFOG: Conservative treatment in epithelial ovarian cancer: results of a multicentre study of the GCCLCC (Groupe des Chirurgiens de Centre de Lutte Contre le Cancer) and SFOG (Soci_et_e Francaise d’Oncologie Gyn_ecologique). Hum Reprod 2005, 20: 1379–1385. 10.1093/humrep/deh777CrossRefPubMed

30.

Zanetta G, Chiari S, Rota S, Bratina G, Maneo A, Torri V, Mangioni C: Conservative surgery for stage I ovarian carcinoma in women of childbearing age. Br J Obstet Gynaecol 1997, 104: 1030–1035. 10.1111/j.1471-0528.1997.tb12062.xCrossRefPubMed

31.

Weber S, McCann CK, Boruta DM, Schorge JO, Growdon WB: Laparoscopic surgical staging of early ovarian cancer. Rev Obstet Gynecol 2011, 4: 117–122.PubMedCentralPubMed

32.

Vrijland WW, Jeekel J, van Geldorp HJ, Swank DJ, Bonjer HJ: Abdominal adhesions: intestinal obstruction, pain, and infertility. Surg Endosc 2003, 17: 1017–1022. 10.1007/s00464-002-9208-9CrossRefPubMed

33.

Milingos S, Kallipolitis G, Loutradis D, Liapi A, Mavrommatis K, Drakakis P, Tourikis J, Creatsas G, Michalas S: Adhesions: laparoscopic surgery versus laparotomy. Ann N Y Acad Sci 2000, 900: 272–285.CrossRefPubMed

Title: Laparoscopic fertility-sparing surgery for early stage ovarian cancer: a single-centre case series and systematic literature review
Authors: Antonella Cromi
Giorgio Bogani
Stefano Uccella
Jvan Casarin
Maurizio Serati
Fabio Ghezzi
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of Ovarian Research / Issue 1/2014
Electronic ISSN: 1757-2215
DOI: https://doi.org/10.1186/1757-2215-7-59

ACC 2024 Congress

Springer Medicine

Laparoscopic fertility-sparing surgery for early stage ovarian cancer: a single-centre case series and systematic literature review

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2014

Low dose of rFSH [100 IU] in controlled ovarian hyperstimulation response: a pilot study

Luteal activity of pregnant rats with hypo-and hyperthyroidism

Interleukin-2 and SOCS-1 proteins involvement in the pathophysiology of severe ovarian hyperstimulation syndrome-a preliminary proof of concept

Preoperative HE4 and ROMA values do not improve the CA125 diagnostic value for borderline tumors of the ovary (BOT) – a study of the TOC Consortium

The MOC31PE immunotoxin reduces cell migration and induces gene expression and cell death in ovarian cancer cells

Ovarian tissue cryopreservation followed by controlled ovarian stimulation and pick-up of mature oocytes does not impair the number or quality of retrieved oocytes