CONSERVATIVE SURGERY FOR OVARIAN-CANCER AND EFFECT ON FERTILITY

Objective: A survey that compared two alternatives (conservative and r adical surgery) is presented on ovarian cancer treatment evaluating it s effect on progression-free survival and fertility, in a 10-year time period, in Mexican women. Methods: 72 women between 11 and 58 years o ld with unilateral ovarian cancer in different stages were studied. Se veral methods were analyzed: (1) progression-free survival, using Mant el and Haenzsel test to compare in terms of life curves and the Kaplan -Meier method. The exposure variable was surgery type, using the Mante l-Cox test to evaluate the difference in life curves by clinical stage s and by surgery type; (2) fertility was evaluated in women who receiv ed conservative surgery, considering the cumulative pregnancy rate in women successfully pregnant after surgical and/or adjuvant treatment. Results: There were no differences in survival curves when evaluating progression-free survival, in either group (Z = 1.09 and Pr > (z) = 0. 27). During the study period, we found that 87.5% of patients were ali ve with no evidence of disease. There were no differences in survival curves when evaluating progression-free survival according to surgery type and clinical stage (chi(2) = 0.66, P = 0.88). Restart of menstrua tion in patients with conservative surgery occurred before 6 months in 89% of the sample, 22 women with possible parity had a 59.1% cumulati ve pregnancy rate. Conclusions: The outcomes from this survey carried out in Mexico show that conservative treatment of ovarian cancer in ea rly clinical stages is an efficient alternative to preserve reproducti ve function in young women, and does not show differences in progressi on-free survival compared to radical surgery. (C) 1997 International F ederation of Gynecology and Obstetrics.