Clinical data, demographic, diagnostic and treatment information were primarily collected from the patients' charts. Patients were seen at 3-month intervals after initial diagnosis for a 2year period, thereafter at 6-month intervals for another 2 years and then once a year to evaluate for sonographic and clinical signs of relapse. The patients' data were further reviewed for the surgical procedure performed. Radicality varying from unilateral adnexectomy, in this study referred to as fertility sparing surgery, to hysterectomy with bilateral adnexectomy, omentectomy and lymphadenectomy were recorded. Bilateral adnexectomy, hysterectomy, omentectomy, cytology, and several peritoneal biopsies were regarded as full staging. Tumor typing and staging were performed by the department of pathology according to the criteria of the International Federation of Gynaecologists and Obstetricians (FIGO) and the International Union against Cancer (IUCC).The following parameters were registered for each patient: age at primary diagnosis, menopausal stage, age at menopause, surgical procedure performed, tumor type and stage. Also, the presence of BOT cells in ascites was recorded. In follow-up, the occurrence of relapse, time to relapse, death and survival time were registered. The main outcomes assessed were disease recurrence and survival.Statistical analysis was performed using MedCalc (Version 8.1; MedCalc Software, Mariakerke, Belgium). All values are given as mean and standard deviation. To test differences between continuous variables for statistical significance, the Mann-Whitney test for unpaired variables was applied. For categorical data, the chi-square test was used. For the comparison of survival times, Kaplan-Meier curves were drawn for different patient groups. The chi-square statistic of the logrank test was calculated to test differences between survival curves for significance. p values less than 0.05 were considered as statistically significant. ResultsAltogether, 113 patients could be identified, including 19 women with fertility sparing surgery. Mean follow-up time was 9.6 AE 6.6 years (minimum 6 months, maximum 23.5 years, median 7.9 years). Mean age at primary diagnosis was 51.2 AE 16.6 years; altogether 36 women (32%, 36/113) were under the age of 40. About half of the patients were premenopausal (56/113). Histology revealed a serous tumor in 73 women (64.6%), mucinous in 39 (34.5%) and endometrioid in one case (0.9%). 63 patients (55.8%) were diagnosed at FIGO stage Ia, 13 (11.5%) at stage Ib, 18 (15.9%) at stage Ic, 7 (6.3%) at stage II and 12 (10.6%) at stage III (Table 1). Cytology was positive for tumor cells in five cases (4.4%, 5/113). Implants were found in 19 patients: 11 were invasive (57.9%) and 8 non-invasive implants (42.1%). Localization of implants was the omentum (42.1%), the peritoneum (31.6%), diaphragm (10.5%) and bladder (10.5%). The mesosalpinx, uterus, umbilicus and kidney were affected in less than 10%.An adjuvant platinum-based chemotherapy was recommended to 11 patients diagnosed wi...
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