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10.1245/s10434-007-9651-x
Annals of Surgical Oncology 15:478-483 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Prognosis of Patients Who Relapse after Fertility-Sparing Surgery in Epithelial Ovarian Cancer

Olivier Marpeau, MD1, Jeanne Schilder, MD2, Yaelle Zafrani, MD1, Catherine Uzan, MD1, Sebastien Gouy, MD1, Catherine Lhommé, MD1 and Philippe Morice, MD1

1 Institut Gustave Roussy, 39 rue Camille Desmoulins, Villejuif, FRANCE
2 Indiana University School of Medicine, Indianapolis, IN, Indiana, USA

Correspondence: Address correspondence and reprint requests to: Philippe Morice, MD; E-mail: morice{at}igr.fr

Background: The prognosis for patients who develop a recurrence after fertility-sparing surgery for epithelial ovarian cancer (EOC) remains unclear. This is the first study to evaluate survival in patients who have developed a recurrence in this context.

Methods: The outcomes of relapsed patients reported in the literature in the four main series of fertility-sparing surgery for EOC were reviewed and updated (where feasible).

Results: Twenty-three of the 166 patients in the series were reported to have recurrent disease. The site of the recurrence was the peritoneum (+/– remaining ovary) in 17 patients, and distant in six patients. Twelve patients died of recurrent disease, two are still alive with persistent disease, eight are disease-free, and one is alive but her exact status is not known. Among eight patients (34%) with an isolated recurrence on the remaining ovary, two died and one was lost to follow-up.

Conclusion: In this carefully monitored population, including systematic radiological examinations, the rate of isolated recurrences on the spared ovary is low. Recurrence in these patients carries a poor prognosis. Such results suggest that initial selection of candidates for fertility-sparing surgery should be carefully defined to reduce the rate of recurrences that carry a poor prognosis.

Key Words: Ovarian cancer • Conservative surgery • Prognosis • Outcomes • Recurrence






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