Conservative Management Of the Patient with Early Gynecologic Cancer

DiSaia, Philip J.

doi:10.3322/canjclin.39.3.135

Cited by 24 publications

(17 citation statements)

References 11 publications

(1 reference statement)

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“…27 DiSaia argues that lymph node involvement is rare in patients with Stage IA Grade 1 and 2 lesions and accordingly do not recommend a routine lymphadenectomy in these cases. 6 However, in a noteworthy series recently reported by Meier, in approximately 96 patients with Stage I disease 7% with Stage IA and IB and 14% of patients with Stage IC disease had positive lymph nodes. 26 Baiocchi et al reported a rate of lymph node involvement of 12.9% and 14.7% in patients with Stage IA and IB disease, respectively.…”

Section: Discussionmentioning

confidence: 94%

“…DiSaia and Moore et al recommended performing a radical surgery when the desire for reproduction is no longer being considered. 6,22 Zanetta et al reported 27 pregnancies in 20 patients treated conservatively. 8 In our series, only four pregnancies in four patients were observed.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors suggested that conservative surgery could be performed in patients with Stage IA disease, according to the 1987 International Federation of Gynecology and Obstetrics (FIGO) classification, 6 but consistent data about the clinical outcome after such treatment are rare. Recent Italian studies seem to suggest that conservative surgery could be safely performed in patients with Stage IC disease and even in patients with a more advanced stage (Stage III).…”

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confidence: 99%

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Results of conservative treatment in epithelial ovarian carcinoma

Morice

Wicart-Poque

Rey

et al. 2001

Cancer

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Results of conservative treatment in epithelial ovarian carcinoma

Morice

Wicart-Poque

Rey

et al. 2001

Cancer

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“…Initially, fertility-sparing surgery was performed in young women with stage IA grade I EOC, with negative peritoneal cytology, capsule invasion, tumor rupture, or tumor adhesion to surrounding tissues [24,26,40]. Subsequent studies, however, suggested that fertility-sparing surgery is safe for patients with more advanced disease, including patients with early-stage EOC without high-risk factors, including women with stage IA grade 2 and stage IB grade 1-2 disease (table 1).…”

Section: Text Of Reviewmentioning

confidence: 99%

Fertility-Sparing Surgery for Young Women with Early-Stage Epithelial Ovarian Cancer

Nam

2013

Gynecol Obstet Invest

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Background/Aims: To discuss the latest findings on oncologic and reproductive outcomes of fertility-sparing surgery in epithelial ovarian cancer (EOC) and to suggest proper indications for this treatment. Methods: A search of Medline database was performed for articles dealing with fertility-sparing surgery for EOC published in the English literature between January 1, 1969, and October 1, 2012. Results: To date, 918 patients with EOC underwent fertility-sparing surgery; 109 (11.9%) had disease recurrence and 48 (5.2%) died of disease. Retrospective studies suggest that fertility-sparing surgery may be safely performed in young women with a strong desire to preserve fertility and with nonclear cell histology, FIGO stage IA, IC and grade 1-2 disease or clear cell histology and FIGO stage IA disease. To date, 177 patients have succeeded in achieving 242 pregnancies, resulting in 214 term (88%) and 1 preterm (0.4%) births. Miscarriage rate was about 10% (25/242) and ectopic pregnancy rate was 0.8% (2/242) after fertility-sparing surgery. No congenital anomaly has been reported. Conclusions: Although randomized controlled trials have yet to be performed, many studies have suggested that fertility-sparing surgery is safe, with promising reproductive outcomes. Cautious selection of patients is important because of 5.2% mortality and 11% recurrence after this surgery.

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“…Literature on the conservative management of EOC in selected patients is limited (DiSaia, 1989). Only four studies involving relatively large numbers of patients have been published (Colombo et al, 1994;Schilder et al, 2002;Park et al, 2008;Kajiyama et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma

Zhu

Liang

et al. 2011

J. Zhejiang Univ. Sci. B

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Abstract:Objective: To assess the clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma (EOC). Methods: A retrospective study of young EOC inpatients (≤40 years old) was performed during January 1994 and December 2010 in eight institutions. Results: Data were analyzed from 94 patients treated with fertility-sparing surgery with a median follow-up time of 58.7 months. As histologic grade increased, overall survival (OS) and disease-free survival (DFS) of patients receiving fertility-sparing surgery declined. Neither staging surgery nor laparoscopy of early stage EOC with conservative surgery had a significant effect on OS or DFS. Normal menstruation recommenced after chemotherapy in 89% of the fertility-sparing group. Seventeen pregnancies among twelve patients were achieved by the end of the follow-ups. Conclusions: Fertility-sparing treatment for patients with EOC Stage I Grade 1 could be cautiously considered for young patients. The surgical procedure and surgical route might not significantly influence the prognosis. Standard chemotherapy is not likely to have an evident impact on ovarian function or fertility in young patients.

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Conservative Management Of the Patient with Early Gynecologic Cancer

Cited by 24 publications

References 11 publications

Results of conservative treatment in epithelial ovarian carcinoma

Results of conservative treatment in epithelial ovarian carcinoma

Fertility-Sparing Surgery for Young Women with Early-Stage Epithelial Ovarian Cancer

Clinical outcomes of fertility-sparing treatments in young patients with epithelial ovarian carcinoma

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