CONSERVATIVE SURGERY FOR STAGE-I OVARIAN-CARCINOMA IN WOMEN OF CHILDBEARING AGE

Objective To assess the results of a policy of tailored conservative s urgical management for young women with stage I ovarian carcinomas. De sign Retrospective study. Participants Ninety-nine women aged 40 years or younger who underwent either primary surgery in our department or were referred after primary surgery performed elsewhere. Methods Of th e 99 women in our study, 56 underwent fertility-sparing surgery and 43 more radical surgery. Minimal requirements for conservative managemen t were adequate staging and complete information about the therapeutic options. Factors important in the choice of the treatment were, age, wish to preserve fertility, histologic type and grade, and the stage o f the tumour. Results Conservative treatment was conducted in 84% of n ulliparous and in 33% of parous women; 62% of grade 1 tumours, 48% of grade 2, and 50% of grade 3 were treated conservatively. With a median follow up of seven years, we observed five recurrences (9%) of carcin oma in women treated conservatively and five (12%) in those treated mo re radically. Two women (one in each treatment arm) were saved after r ecurrence. Two recurrences after conservative surgery involved the res idual ovary (3.6%). Two women developed borderline tumour in the contr alateral ovary and both were treated by surgery. Conclusion After adeq uate staging and accurate information is given to the patient, conserv ative treatment may be safe in some women with early ovarian cancer. T he risk of recurrence in the contralateral ovary is low. Conservative surgery may be also considered in some Stage I grade 3 tumours and in some women with stage IC tumours.