Author(s): Ana Victoria V. Dy Echo, M.D., F.P.O.G.S. and Jericho Thaddeus P. Luna, M.D., F.P.O.G.S.

Abstract:
As ovarian cancer is increasingly diagnosed among reproductive aged women, fertility sparing surgery (FSS) becomes an important management option.

Objective:
A five-year (2005-2009) retrospective study was conducted at a tertiary hospital to determine the fertility and clinical outcomes of ovarian cancer patients who underwent FSS.

Methodology:
Patients 16-40 years old who underwent FSS were evaluated. Review of medical records was done to determine clinic-surgico-pathologic demographics. Menstrual, fertility and clinical outcomes were the main outcomes measured.

Results:
Forty-four cases (mean age 24 years) were evaluated: 27 epithelial tumors, 16 germ cell tumors and 1 sex cord stromal tumor. Forty-one cases (93.18%) were stage I, while 3 cases (6.82%) had advanced stages. Complete surgical staging was done in 19 (43.18%) patients. At the end of treatment, all patients had restoration of menses 1-2 months after initial surgery with no significant interruption in menses among the 7 patients given platinum-based chemotherapy. There were 15 pregnancies (83.33%), with 2 patients having 2 pregnancies each. There were only 5 patients (27.78%) with infertility, 3 of which already had infertility prior to the surgery. There were 8 (18.18%) cases of tumor persistence/recurrence, all of which were malignant germ cell tumors without adjuvant chemotherapy.

Conclusion:
This study suggests that FSS is a safe and acceptable treatment for reproductive-age women, particular those less than 30 years old with no history of infertility, with either stage I epithelial tumors (low malignant potential and frank carcinoma) or malignant germ cell tumors with assured adjuvant chemotherapy.

Key words: fertility-sparing surgery, ovarian cancer

DOI: https://doi.org/10.61662/PCS_ckxb2044