Outcome of Reproductive Age Women With Stage IA or IC Invasive Epithelial Ovarian Cancer Treated With Fertility-Sparing Therapy

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The authors conducted a review of the medical records of all patients less than 40 years of age who were treated with unilateral oophorectomy for stage IA and stage IC epithelial ovarian cancer at one of the eight participating institutions from 1965 to 2000. Fifty-two patients were identified, and they or their families were contacted to provide long-term outcome information. The patients averaged 26 years of age (range, 11-40). The most common cell type was mucinous (48%), followed by serous and endometrioid (19% each), clear cell (10%), and mixed (4%). Seventy-three percent of the tumors were well differentiated, 17% were moderately differentiated, and 10% were poorly differentiated. Eleven patients with stage IA and 8 with stage IC disease received adjuvant chemotherapy. Five of the 52 patients (4 with stage IA and 1 with stage IC disease) experienced a tumor recurrence at 78, 69, 13, 9, and 8 months. Three of the recurrences were in the contralateral ovary. These three women were treated by reparation, and one also received postoperative chemotherapy. They are all alive with no evidence of disease after a mean follow-up of 21 months. One patient had a recurrence in the abdominal peritoneum 9 months after treatment. A second had a pulmonary metastasis diagnosed 78 months after initial treatment. Despite additional chemotherapy or chemoradiation, both of these women died of disease. One patient developed a distinctly different second primary ovarian tumor in the contralateral ovary. Another patient developed an adenosquamous cancer of the endometrium. Twenty-four of the 52 patients reported having attempted pregnancy. Seventeen of them were able to conceive, and these patients have had 26 term pregnancies with 5 spontaneous abortions. No congenital anomalies were reported.