Current limits of conservative treatment in ovarian cancer.
Journal
Current opinion in oncology
ISSN: 1531-703X
Titre abrégé: Curr Opin Oncol
Pays: United States
ID NLM: 9007265
Informations de publication
Date de publication:
01 09 2023
01 09 2023
Historique:
medline:
9
8
2023
pubmed:
27
7
2023
entrez:
27
7
2023
Statut:
ppublish
Résumé
Fertility-sparing surgery in ovarian cancer is an increasing need in gynecology-oncology clinical practice because of the frequent childbearing delay in developed countries. As the evidence in literature is based on observational studies, this review focuses on summarizing the most recent and relevant evidence for the conservative management of young patients with ovarian cancer. Staging surgery is mandatory in epithelial ovarian tumors. In sex cord-stromal tumors, fertility-sparing surgery is only recommended in FIGO stage IA. Due to its good prognosis, conservative treatment is possible in some cases of advanced disease of germ cell tumors and borderline tumors. Cystectomy is a reasonable option in serous borderline tumors but is not recommended in other tumor subtypes. Successful conception rates after fertility-sparing surgery ranges from 30 to 60%. Fertility-sparing surgery is a well tolerated option in young women with early-stage ovarian cancer with acceptable reproductive outcomes.
Identifiants
pubmed: 37498109
doi: 10.1097/CCO.0000000000000970
pii: 00001622-202309000-00007
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
389-393Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71:209–249.
Mandelbaum RS, Klar M, Takiuchi T, et al. Fertility-sparing treatment for early-stage epithelial ovarian cancer: Contemporary oncologic, reproductive and endocrinologic perspectives. J Obstet Gynaecol Res 2020; 46:1263–1281.
Maltaris T, Boehm D, Dittrich R, et al. Reproduction beyond cancer: a message of hope for young women. Gynecol Oncol 2006; 103:1109–1121.
Elzakkers JCJ, van der Aa MA, van Altena AM, et al. Further insights into the role of tumour characteristics in survival of young women with epithelial ovarian cancer. Gynecol Oncol 2019; 155:213–219.
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.
Gorostidi M, Gil-Ibañez B, Alonso S, et al. Fertility preservation treatment of gynecological cancer patients in Spain: a national survey (GOFER study). Arch Gynecol Obstet 2020; 301:793–800.
Querleu D, Planchamp F, Chiva L, et al. European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery. Int J Gynecol Cancer 2017; 27:1534–1542.
Santos ML, Pais AS, Almeida Santos T. Fertility preservation in ovarian cancer patients. Gynecol Endocrinol 2021; 37:483–489.
Ledermann JA, Raja FA, Fotopoulou C, et al. ESMO Guidelines Working Group. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24:vi24–vi32.
Morice P, Camatte S, El Hassan J, et al. Clinical outcomes and fertility after conservative treatment of ovarian borderline tumors. Fertil Steril 2001; 75:92–96.
Ditto A, Martinelli F, Lorusso D, et al. Fertility sparing surgery in early stage epithelial ovarian cancer. J Gynecol Oncol 2014; 25:320–327.
Swift BE, Covens A, Mintsopoulos V, et al. Oncologic and pregnancy outcomes after fertility-sparing surgery for stage I, low-grade endometrioid ovarian cancer. Int J Gynecol CAncer 2022; 32:525–531.
Lin W, Cao D, Shi X, et al. Oncological and reproductive outcomes after fertility-sparing surgery for stage I mucinous ovarian carcinoma. Front Oncol 2022; 12:856818.
Suh DH, Kim TH, Kim JW, et al. Improvements to the FIGO staging for ovarian cancer: reconsideration of lymphatic spread and intraoperative tumor rupture. J Gynecol Oncol 2013; 24:352–358.
Kajiyama H, Mizuno M, Shibata K, et al. Recurrence-predicting prognostic factors for patients with early-stage epithelial ovarian cancer undergoing fertility-sparing surgery: a multiinstitutional study. Eur J Obstet Gynecol Reprod Biol 2014; 175:97–102.
Nasioudis D, Heyward QD, Ko EM, et al. Fertility-sparing surgery for patients with stage IC2 or IC3 epithelial ovarian carcinoma: any evidence of safety? Int J Gynecol Cancer 2022; 32:165–171.
Ray-Coquard I, Morice P, Lorusso D, et al. Nonepithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29:iv1–iv18.
Ertas IE, Taskin S, Goklu R, et al. Long-term oncological and reproductive outcomes of fertility-sparing cytoreductive surgery in females aged 25 years and younger with malignant ovarian germ cell tumors: malignant ovarian germ cell tumors. J Obstet Gynaecol Res 2014; 40:797–805.
Minig L, Gracia Segovia M, Arencibia O, et al. Oncological outcomes among young women with nonepithelial ovarian cancer: the YOC-Care study (Young Ovarian Cancer - Care). Int J Gynecol Cancer 2023; 33:915–921.
Sessa C, Schneider DT, Planchamp F, et al. ESGO-SIOPE guidelines for the management of adolescents and young adults with nonepithelial ovarian cancers. Lancet Oncol 2020; 21:e360–e368.
Ray-Coquard I, Brown J, Harter P, et al. Gynecologic Cancer InterGroup (GCIG) Consensus Review for ovarian sex cord stromal tumors. Int J Gynecol Cancer 2014; 24: (Suppl 3): S42–S47.
Li J, Chu R, Wang Z, et al. Analysis of the safety and pregnancy outcomes of fertility-sparing surgery in ovarian malignant sex cord-stromal tumours: a multicentre retrospective study. Clin Oncol 2023; 35:e206–e214.
Kuji S, Harada M, Yoshioka N, et al. Survival and reproductive outcomes after fertility-sparing surgery performed for borderline epithelial ovarian tumor in Japanese adolescents and young adults: results of a retrospective nationwide study. J Obstet Gynaecol Res 2022; 48:806–816.
Bourdel N, Huchon C, Abdel Wahab C, et al. Borderline ovarian tumors: Guidelines from the French National College of Obstetricians and Gynecologists (CNGOF). Eur J Obstet Gynecol Reprod Biol 2021; 256:492–501.
Falcone F, Malzoni M, Carnelli M, et al. Fertility-sparing treatment for serous borderline ovarian tumors with extra-ovarian invasive implants: analysis from the MITO14 study database. Gynecol Oncol 2022; 165:302–308.
Colombo N, Sessa C, du Bois A, et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol 2019; 30:672–705.
Kajiyama H, Suzuki S, Niimi K, et al. Oncologic and reproductive outcomes of cystectomy as a fertility-sparing treatment for early-stage epithelial ovarian cancer. Int J Clin Oncol 2019; 24:857–862.
Ohara T, Kuji S, Takenaga T, et al. Current state of fertility preservation for adolescent and young adult patients with gynecological cancer. Int J Clin Oncol 2022; 27:25–34.
Gouy S, Saidani M, Maulard A, et al. Staging surgery in early-stage ovarian mucinous tumors according to expansile and infiltrative types. Gynecol Oncol Rep 2017; 22:21–25.
Li T, Liu Y, Xie S, Wang H. Systematic pelvic and para-aortic lymphadenectomy during fertility-sparing surgery in patients with early-stage epithelial ovarian cancer: a retrospective study. Front Oncol 2022; 12:913103.
Minig L, Heitz F, Cibula D, et al. Patterns of lymph node metastases in apparent stage I low-grade epithelial ovarian cancer: a multicenter study. Ann Surg Oncol 2017; 24:2720–2726.
Stewart K, Campbell S, Frumovitz M, et al. Fertility considerations prior to conservative management of gynecologic cancers. Int J Gynecol Cancer 2021; 31:339–344.
Mahdi H, Swensen RE, Hanna R, et al. Prognostic impact of lymphadenectomy in clinically early stage malignant germ cell tumour of the ovary. Br J Cancer 2011; 105:493–497.
Matei D, Brown J, Frazier L. Updates in the management of ovarian germ cell tumors. Am Soc Clin Oncol Educ Book 2013; doi: 10.14694/EdBook_AM.2013.33.e210.
doi: 10.14694/EdBook_AM.2013.33.e210
Durmuş Y, Kiliç Ç, Çakir C, et al. Sertoli-Leydig cell tumor of the ovary: analysis of a single institution database and review of the literature. J Obstet Gynaecol Res 2019; 45:1311–1318.
Bergamini A, Luisa FM, Dellino M, et al. Fertility sparing surgery in sex-cord stromal tumors: oncological and reproductive outcomes. Int J Gynecol Cancer 2022; 32:1063–1070.
Li J, Li J, Jiang W. Oncological prognosis and fertility outcomes of different surgical extents for malignant ovarian sex-cord stromal tumors: a narrative review. Cancer Manag Res 2022; 14:697–717.
Wang D, Cao D, Jia C, et al. Analysis of oncologic and reproductive outcomes after fertility-sparing surgery in apparent stage I adult ovarian granulosa cell tumors. Gynecol Oncol 2018; 151:275–281.
Wang D, Jia C, Cheng H, et al. Analysis of outcomes and prognostic factors after fertility-sparing surgery in patients with early stage juvenile granulosa cell tumor of the ovary: experience from a tertiary center. J Pediatr Adolesc Gynecol 2022; 35:486–491.
Negri S, Grassi T, Fruscio R. Use of staging for sex cord stromal tumours. Curr Opin Oncol 2022; 34:504–510.
Ertas IE, Gungorduk K, Taskin S, et al. Prognostic predictors and spread patterns in adult ovarian granulosa cell tumors: a multicenter long-term follow-up study of 108 patients. Int J Clin Oncol 2014; 19:912–920.
Karalok A, Turan T, Ureyen I, et al. Prognostic factors in adult granulosa cell tumor: a long follow-up at a single center. Int J Gynecol Cancer 2016; 26:619–625.
Nasioudis D, Kanninen TT, Holcomb K, et al. Prevalence of lymph node metastasis and prognostic significance of lymphadenectomy in apparent early-stage malignant ovarian sex cord-stromal tumors. Gynecol Oncol 2017; 145:243–247.
Ikeda Y, Yoshihara M, Yoshikawa N, et al. Is cystectomy an option as conservative surgery for young patients with borderline ovarian tumor? A multiinstitutional retrospective study. Int J Gynecol Obstet 2022; 157:437–443.
Zapardiel I, Rosenberg P, Peiretti M, et al. The role of restaging borderline ovarian tumors: single institution experience and review of the literature. Gynecol Oncol 2010; 119:274–277.
Bentivegna E, Maulard A, Miailhe G, et al. Gynaecologic cancer surgery and preservation of fertility. J Visc Surg 2018; 155 Suppl 1:S23–S29.
Shiota M, Kotani Y, Umemoto M, et al. Study of the correlation between tumor size and cyst rupture in laparotomy and laparoscopy for benign ovarian tumor: Is 10 cm the limit for laparoscopy?: Cyst rupture according to ovarian tumor size. J Obstet Gynaecol Res 2012; 38:531–534.
Xie Q, Meng X, Liao Q. Oncologic outcomes of fertility-sparing surgery in early stage epithelial ovarian cancer: a population-based propensity score-matched analysis. Arch Gynecol Obstet 2022; 306:1679–1688.
Park JY, Suh DS, Kim JH, et al. Outcomes of fertility-sparing surgery among young women with FIGO stage I clear cell carcinoma of the ovary. Int J Gynecol Obstet 2016; 134:49–52.
Liu D, Cai J, Gao A, et al. Fertility sparing surgery vs radical surgery for epithelial ovarian cancer: a meta-analysis of overall survival and disease-free survival. BMC Cancer 2020; 20:320.
Kajiyama H, Suzuki S, Yoshikawa N, et al. Fertility-sparing surgery and oncologic outcome among patients with early-stage ovarian cancer ∼propensity score- matched analysis∼. BMC Cancer 2019; 19:1235.
Fruscio R, Ceppi L, Corso S, et al. Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer. Br J Cancer 2016; 115:641–648.
Birge Ö, Bakir MS, Doğan S, et al. Survival analysis and obstetric outcomes in patients with early stage ovarian cancer undergoing fertility-sparing surgery. J Ovarian Res 2022; 15:135.
Nam JH, Park JY. Fertility-sparing surgery for young women with early-stage epithelial ovarian cancer. Gynecol Obstet Invest 2013; 76:14–24.
Chan JK, Tian C, Monk BJ, et al. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer 2008; 112:2202–2210.
Zhang Y-F, Fan Y, Mu Y, et al. Reproductive and oncological outcomes of fertility-sparing surgery in patients with stage I epithelial ovarian cancer: a systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29929.
Cheng X, Cheng B, Wan X, et al. Outcomes of conservative surgery in early epithelial ovarian carcinoma. Eur J Gynaecol Oncol 2012; 33:93–95.
Kashima K, Yahata T, Fujita K, Tanaka K. Outcomes of fertility-sparing surgery for women of reproductive age with FIGO stage IC epithelial ovarian cancer. Int J Gynecol Obstet 2013; 121:53–55.
Bentivegna E, Gouy S, Maulard A, et al. Fertility-sparing surgery in epithelial ovarian cancer: a systematic review of oncological issues. Ann Oncol 2016; 27:1994–2004.
Melamed A, Rizzo AE, Nitecki R, et al. All-cause mortality after fertility-sparing surgery for stage I epithelial ovarian cancer. Obstet Gynecol 2017; 130:71–79.
Park JY, Kim DY, Suh DS, et al. Analysis of outcomes and prognostic factors after fertility-sparing surgery in malignant ovarian germ cell tumors. Gynecol Oncol 2017; 145:513–518.
Morrison A, Nasioudis D. Reproductive outcomes following fertility-sparing surgery for malignant ovarian germ cell tumors: a systematic review of the literature. Gynecol Oncol 2020; 158:476–483.
Brown J, Friedlander M, Backes FJ, et al. Gynecologic Cancer Intergroup (GCIG) Consensus Review for Ovarian Germ Cell Tumors. Int J Gynecol Cancer 2014; 24 (Supp 3):S48–S54.
Graham R, MacDonald ND, Lockley M, et al. Surgical management and outcomes for stage 1 malignant ovarian germ cell tumours: a UK multicentre retrospective cohort study. Eur J Obstet Gynecol Reprod Biol 2022; 271:138–144.
Sun D, Zhi ZF, Fan JT. Could fertility-sparing surgery be considered for stage I ovarian sex cord-stromal tumors? A comparison of the Fine-Gray model with Cox model. Front Oncol 2022; 12:964181.
Nasioudis D, Frey MK, Chapman-Davis E, et al. Safety of fertility-sparing surgery for premenopausal women with sex cord-stromal tumors confined to the ovary. Int J Gynecol Cancer 2017; 27:1826–1832.
Wang D, Jia S, Jia C, et al. Oncological and reproductive outcomes after fertility-sparing surgery in patients with seromucinous borderline ovarian tumor: results of a large retrospective study. Gynecol Oncol 2022; 165:446–452.
Rodolakis A, Nikolaos T. Fertility preservation for gynecologic cancer patients. In Ayhan A, editor. ESGO textbook of gynecological oncology . 2017. pp. 1051–1062.
Canlorbe G, Chabbert-Buffet N, Uzan C. Fertility-sparing surgery for ovarian cancer. J Clin Med 2021; 10:4235.
Kasaven LS, Chawla M, Jones BP, et al. Fertility sparing surgery and borderline ovarian tumours. Cancers 2022; 14:1485.
Gaughran J, Rosen O'Sullivan H, Lyne T, et al. Fertility preserving surgery outcomes for ovarian malignancy: data from a Tertiary Cancer Centre in Central London. J Clin Med 2022; 11:3195.
Sobiczewski P, Piatek S, Michalski W, et al. Obstetric outcomes after conservative management of ovarian borderline tumors in women of reproductive age: a single center experience. Eur J Obstet Gynecol Reprod Biol 2022; 269:126–131.
Zapardiel I, Cruz M, Diestro MD, et al. Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers. Hum Reprod Update 2016; 22:281–305.