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Volume 6, Issue 3 (7-2008)
IJRM 2008, 6(3): 95-0 |
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Ghaemmaghami F, Karimi Zarchi M, Naseri A, Mousavi A S, Modarres Gilani M, Ramezanzadeh F. Conservative management in young patients with borderline and malignant ovarian tumors: outcomes and pregnancies. IJRM 2008; 6 (3) :95-0
URL: http://ijrm.ir/article-1-108-en.html
URL: http://ijrm.ir/article-1-108-en.html
Fatemeh Ghaemmaghami * 
1, Mojgan Karimi Zarchi2 , Azita Naseri3 , Azam Sadat Mousavi4 , Mitra Modarres Gilani4 , Fatemeh Ramezanzadeh5
1, Mojgan Karimi Zarchi2 , Azita Naseri3 , Azam Sadat Mousavi4 , Mitra Modarres Gilani4 , Fatemeh Ramezanzadeh5
1- Gynecology Oncology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran , ftghaemmagh@yahoo.com
2- Gynecology Oncology Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Obstetrics and Gynecology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
4- Gynecology Oncology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
5- Vali-e-Asr, Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
2- Gynecology Oncology Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Obstetrics and Gynecology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
4- Gynecology Oncology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
5- Vali-e-Asr, Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (2356 Views)
Background: Recent studies have showed conservative management in selective patients with borderline and malignant ovarian tumors is safe; therefore this management is considered in patients with ovarian tumor who desire to preserve fertility.
Objective: This study has been performed to evaluate the clinical outcome and fertility in patients with ovarian tumors who were treated conservatively. Materials and Methods: All patients who were treated conservatively (preservation of uterus and at least one ovary) or were on follow-up and had recurrence were evaluated in Vali-e-Asr Hospital during 2000-2004.
Results: Among 410 patients with ovarian tumors, 60 were treated conservatively. Age range was 13-34 years. Twenty-six of patients (43.3%) were desired pregnancy and 34 (56%) patients did not. Three (5%) patients had history of infertility. Histological types of tumors were as follows; 15(25%) borderline tumors, 10(16.7%) epithelial tumors, 26(43.3%) germ cell tumors, and 9(15%) sex cord tumors. Range of follow-up time was 12-48 months. Seven term pregnancies in 6 patients had been occurred, 1 in epithelial group, 2 in germ cell group, 1 in sex cord group and 3 in borderline group. Nine patients had recurrence and 2 patients expired, including one patient with serous cyst carcinoma (Stage IIIC).This patient had refused radical surgery and referred to our center with recurrence. Another patient had immature teratoma (Stage IIIC).
Conclusion: Conservative surgical management in young patients with stage I (grade 1, 2) of epithelial ovarian tumor and sex cord-stromal tumor and in patients with borderline and germ cell ovarian tumors could be performed in order to preserve fertility.
Objective: This study has been performed to evaluate the clinical outcome and fertility in patients with ovarian tumors who were treated conservatively. Materials and Methods: All patients who were treated conservatively (preservation of uterus and at least one ovary) or were on follow-up and had recurrence were evaluated in Vali-e-Asr Hospital during 2000-2004.
Results: Among 410 patients with ovarian tumors, 60 were treated conservatively. Age range was 13-34 years. Twenty-six of patients (43.3%) were desired pregnancy and 34 (56%) patients did not. Three (5%) patients had history of infertility. Histological types of tumors were as follows; 15(25%) borderline tumors, 10(16.7%) epithelial tumors, 26(43.3%) germ cell tumors, and 9(15%) sex cord tumors. Range of follow-up time was 12-48 months. Seven term pregnancies in 6 patients had been occurred, 1 in epithelial group, 2 in germ cell group, 1 in sex cord group and 3 in borderline group. Nine patients had recurrence and 2 patients expired, including one patient with serous cyst carcinoma (Stage IIIC).This patient had refused radical surgery and referred to our center with recurrence. Another patient had immature teratoma (Stage IIIC).
Conclusion: Conservative surgical management in young patients with stage I (grade 1, 2) of epithelial ovarian tumor and sex cord-stromal tumor and in patients with borderline and germ cell ovarian tumors could be performed in order to preserve fertility.
Type of Study: Original Article |
References
1. Zanagnolo V, Sartori E, Trussardi E, Pasinetti B, Maggino T. Preservation of ovarian function, reproductive ability and emotional attitudes in patients with malignant ovarian tumors. European Journal of Obstetrics and Gynecology and Reproductive Biology 2005; 123: 235-243. [DOI:10.1016/j.ejogrb.2005.04.010]
2. Amos CI, Struewing JP, Berchuck. Epithelial ovarian cancer. In: Philip J. Disaia, M.D. William T. Creasman MD. Clinical Gynecology Oncology. DISAIA- CRESMAN; Six edi; 2002: 289-350. [DOI:10.1016/B0-32-301089-X/50014-3]
3. Jonathan S, Berek, Greenlee RT, Scully RE. Epithelial ovarian cancer. In: Jonathan S, Berek, Neville F, Hacker. Practical Gynecology Oncology. Fourth ed. Williams and Wilkins; 2005: 443- 510.
4. Ayhan A, Celik H, Taskiran C, Bozdag G, Aksu T. Oncologic and reproductive outcome after fertility-saving surgery in ovarian cancer. Eur J Gynaecol Oncol 2003; 24: 223-232.
5. Morice P, Wicart-Poque F, Rey A, El-Hassan J, Pautier P, Lhommé C, et al.Results of conservative treatment on epithelial ovarian carcinoma. Cancer 2001;92:2412-2418.
https://doi.org/10.1002/1097-0142(20011101)92:9<2412::AID-CNCR1590>3.0.CO;2-7 [DOI:10.1002/1097-0142(20011101)92:93.0.CO;2-7]
6. Seracchioli R, Venturoli S, Colombo FM, Govoni F, Missiroli S, Bagnoli A.Fertility and Tumor recurrence rate after conservative laparoscopic management of young women with early-stage LMP ovarian tumors, Fertil Stril 2001: 999-1003. [DOI:10.1016/S0015-0282(01)02842-4]
7. Talerman A. Blaunstein's pathology of the female genital tract. Germ cell tumors of the ovary. In: Kurman JK. Blaunstein's pathology of the female genital tract. New York: Springer 2002: 967-1033.
8. Kanazawa K, Suzuki T, Sakumoto K. Treatment of malignant ovarian germ cell tumors with preservation of fertility: reproductive performance after persistent remission. Am J Clin Oncol 2000; 23: 244-248. [DOI:10.1097/00000421-200006000-00007]
9. E1-Lamie IK, Shehata NA, Abou-Loz SK, El-Lamie KI. Conservative surgical management of malignant ovarian germ cell tumors: the experience of the Gynecologic Oncology Unit at Ain Shams University. Eur J Gynaecol Oncol 2000; 21: 605-609.
10. Zanagnolo V, Sartori E, Galleri G, Pasinetti B, Bianchi U. Clinical review of 55 cases of malignant ovarian germ cell tumors.Eur J Gynaecol Oncol 2004; 25: 315-320.
11. Young RH, Scully RE. Ovarian sex cord stromal tumors: recent advances and current status, Clin Obstet Gynaecol 1984; 11: 93
12. Tangir J, Shwartz PE. Fertility preservation in the management of germ cell ovarian cancer. CME J Gynecol Oncol 2003; 8: 117-120
13. Duska LR, Chang YC, Flynn CE, Chen AH, Goodman A, Fuller AF, et al. Epithelial ovarian carcinoma in the reproductive age group.Cancer 1999; 85: 2623-2629.
https://doi.org/10.1002/(SICI)1097-0142(19990615)85:12<2623::AID-CNCR19>3.0.CO;2-O [DOI:10.1002/(SICI)1097-0142(19990615)85:123.0.CO;2-O]
14. Gotlieb WH, Flikker S, Davidson B, Korach Y, Kopolovic J, Ben-baruch G. Borderline tumors of the ovary: fertility treatment, conservative management, and pregnancy outcome. Cancer 1998 82: 141-146.
https://doi.org/10.1002/(SICI)1097-0142(19980101)82:1<141::AID-CNCR17>3.0.CO;2-2 [DOI:10.1002/(SICI)1097-0142(19980101)82:13.0.CO;2-2]
15. Camatte S, Morice P, Pautier P, Atallah D, Duvillard P, Castaigne D. Fertility results after conservative treatment of advanced stage serous borderline tumour of the ovary. BJOG 2002; 109: 376-380. [DOI:10.1111/j.1471-0528.2002.01359.x]
16. Donnez J, Munschke A, Berliere M, Pirard C, Jadoul P, Smets M, Squifflet J. Safety of conservative management and fertility outcome in women with borderline tumors of the ovary. Fertil Steril 2003; 79: 1216-1221. [DOI:10.1016/S0015-0282(03)00160-2]
17. Zanetta G, Chiari S, Rota S, Bratina G, Maneo A, Torri V, et al. Conservative surgery for stage I ovarian carcinoma in women of childbearing age. Br J Obstet Gynaecol 1997; 104: 1030-1035. [DOI:10.1111/j.1471-0528.1997.tb12062.x]
18. Raspagliesi F, Fontanelli R, Paladini D, di Re EM. Conservative surgery in high-risk epithelial ovarian carcinoma. J Am Coll Surg 1997; 185: 457-460. [DOI:10.1016/S1072-7515(97)00066-5]
19. Morice P, Leblanc E, Rey A, Baron M, Querleu D, Blanchot J, et al. Conservative treatment in epithelial ovarian cancer: results of a multicentre study of the GCCLCC (Groupe des Chirurgiens de Centre de Lutte Contre le Cancer) and SFOG (Société Française d'Oncologie Gynécologique). Hum Reprod 2005; 20: 1379-1385. [DOI:10.1093/humrep/deh777]
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