Fertility-Sparing Surgery in Ovarian Cancer Patients: A Life-Saving Option
Key Takeaways
- Fertility-sparing surgery is often safe for stage I epithelial ovarian cancer patients.
- High-grade endometrioid tumors may not benefit from fertility-sparing surgery.
- Fertility counseling is crucial for improving quality of life among young cancer patients.
Did You Know?
Introduction
For women diagnosed with epithelial ovarian cancer, preserving fertility is a significant concern, especially for those under the age of 50. Recent findings suggest that undergoing fertility-sparing surgery does not negatively impact overall survival rates, except for women with high-grade endometrioid tumors.
The Significance of Fertility Preservation
Ovarian cancer is often associated with postmenopausal women, but approximately 14% of cases occur in women under 50 years old, typically presenting in stage I. For these younger patients, the ability to have children in the future remains crucial. Despite this, many do not receive adequate fertility counseling, even though it is linked to improved quality of life and reduced regret.
Research Findings
Bonnie B. Song, MD, and her team conducted a study using data from 3,027 women under the age of 50, diagnosed with stage I epithelial ovarian cancer between 2007 and 2020. The data was sourced from the National Cancer Institute’s Surveillance, Epidemiology, and End Result database. They focused on those who underwent fertility-sparing surgery, which involves preserving one ovary and the uterus for unilateral lesions and preserving the uterus for bilateral lesions.
Trends in Fertility-Sparing Surgery
The research revealed that 17.6% of the women opted for fertility-sparing surgery, with its utilization increasing from 13.4% in 2007 to 21.8% in 2020. This increase was more noticeable among non-Hispanic white women, those with high-grade serous histology, and those in stage IC of the disease.
Survival Rates
The study found that women who underwent fertility-sparing surgery had similar overall 5-year survival rates compared to those who had non-sparing surgery (93.6% vs. 92.1%). This trend persisted across various histological subtypes, including high-grade serous, low-grade serous, clear cell, mucinous, low-grade endometrioid, and mixed histology tumors.
Exceptions in High-Grade Endometrioid Tumors
However, the positive trend did not extend to women with high-grade endometrioid tumors, who experienced lower overall 5-year survival rates (71.9% vs. 93.8%) if they underwent fertility-sparing surgery.
Implications for Bilateral Ovarian Lesions
No significant association was found between fertility-sparing surgery and the survival rates of women with bilateral ovarian lesions.
Need for Further Research
While the findings support the safety of fertility-sparing surgery for many patients, Dr. Song emphasized the need for more research, particularly concerning high-grade endometrioid tumors. Early studies on hybrid epithelial ovarian cancer have shown mixed outcomes, highlighting the necessity for ongoing investigation.
Conclusion
Considering the comparable survival rates, fertility-sparing surgery presents a viable option for many younger women diagnosed with stage I epithelial ovarian cancer. This practice needs to become more mainstream, with improved fertility counseling services to enhance patient quality of life.
Dr. Song's Remarks
Dr. Song mentioned that the current data underscore the potential for fertility preservation in specific ovarian cancer patients. Still, patients with high-grade endometrioid tumors require more cautious consideration and further validation studies.
