(4)いま改めて上皮性卵巣癌における妊孕性温存について考える : どこまでが対応可能か?(<特集>第62回学術講演会シンポジウム1 婦人科癌における妊孕性温存治療(手術および薬物療法))

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Objectives: Surgical management of epithelial ovarian cancer (EOC) consists of hysterectomy with bilateral oophorectomy with staging surgery. The purpose of this study was to clarify the clinical outcome of patients with stage I A or more advanced EOC treated with fertility-sparing surgery (FSS). Methods: Demographic and clinicopathologic data were obtained from the Tokai Ovarian Tumor Study Group, consisting of Nagoya University Hospital and affiliated hospitals between 1986 and 2007. After a central pathological review and search of the medical records from multiple institutions, a total of 74 stage I EOC patients treated with FSS (Group 1) and 498 stage I EOC patients treated with conventional surgery {Group 2(n=52), under 40y.o.; Group 3(n=446), over 41y.o} were retrospectively evaluated in the current study. Survival curves were calculated using the Kaplan-Meier method. Differences in survival rates were analyzed using the log-rank test. Results: The median follow-up time of Group 1 was 62.5 months. Nine patients experienced recurrences {I A, 2; I B, 1; I C (surface involvement), 1; and I C (positive cytology), 5}. However, all patients with stage I C (capsule rupture) (n=21) were alive without recurrence. Moreover, there were no significant differences in the overall survival (OS) and disease-free survival (DFS) among the Group 1〜3 (OS, P=0.802; DFS, P=0.765). Fourteen newborns were obtained in 12 patients. In this analysis, a total of 13 clear-cell carcinoma (CCC) patients treated with FSS were included. Twelve patients were alive and one patient with stage I C (2) died of the disease at a follow-up time of 36.8 months. Five newborns were obtained in five CCC patients. Conclusions: FSS may be considered a treatment option in women with stage I EOC, even in those with stage I C (capsule rupture) or more wishing to bear children. Furthermore, it seems that, in selected CCC patients, this surgical approach could be adopted although this should be investigated by additional studies in larger series.
2010-10-01

(4)いま改めて上皮性卵巣癌における妊孕性温存について考える : どこまでが対応可能か?(<特集>第62回学術講演会シンポジウム1 婦人科癌における妊孕性温存治療(手術および薬物療法))

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(4)いま改めて上皮性卵巣癌における妊孕性温存について考える : どこまでが対応可能か?(<特集>第62回学術講演会 シンポジウム1 婦人科癌における妊孕性温存治療(手術および薬物療法))

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(4)いま改めて上皮性卵巣癌における妊孕性温存について考える : どこまでが対応可能か?(<特集>第62回学術講演会シンポジウム1 婦人科癌における妊孕性温存治療(手術および薬物療法))