Long term follow up of patients with an isolated ovarian recurrence after conservative treatment of epithelial ovarian cancer: review of the results of a international multicenter study comprising 545 patients

Capsule:
Long-term survival of epithelial ovarian cancer patients with isolated ovarian recurrence after conservative treatment remains favorable; grade 3 tumors (compared with grades 1/2) have a higher rate of extraovarian recurrences.

Authors:
Enrica Bentivegna, M.D., Robert Fruscio, M.D., Stephanie Roussin, M.D., Lorenzo Ceppi, M.D., Toyomi Satoh, M.D., Ph.D., Hiroaki Kajiyama, M.D., Ph.D., Catherine Uzan, M.D., Ph.D., Nicoletta Colombo, M.D., Ph.D., Sebastien Gouy, M.D., Ph.D., Philippe Morice, M.D., Ph.D.

Volume 104, Issue 5, Pages 1319-1324

Abstract:

Objective:
To determine the long-term outcomes of patients with an isolated ovarian recurrence after fertility sparing surgery (FSS) for epithelial ovarian cancer (EOC) and to evaluate the recurrence rates (and location) according to the new 2014 International Federation of Gynecology and Obstetrics (FIGO) staging system.

Design:
Retrospective multicenter study.

Setting:
Teams having reported recurrence after FSS for EOC.

Patient(s):
Four series comprising 545 patients undergoing FSS and 63 (12%) recurrences.

Intervention(s):
FSS (salpingo-oophorectomy for a majority of cases) for EOC.

Main Outcomes Measure(s):
Recurrences rates and characteristics of recurrent disease.

Result(s):
Among 63 recurrent patients, 24 (38%) recurrences were isolated on the spared ovary, and 39 (62%) arose at an extraovarian site. Among the patients with an isolated ovarian recurrence, three patients died after a median follow-up period of 186 months (range: 28–294 months). Among the patients with recurrent extraovarian disease, 24 died and 7 were alive with persistent disease after a median follow-up period of 34 months (range: 3–231 months). The overall rate of isolated ovarian and extrapelvic recurrences was higher for grade 3 tumors (compared with grades 1/2).

Conclusion(s):
The long-term survival of patients with an isolated ovarian recurrence after FSS for EOC remains favorable. The prognosis of patients with an extraovarian recurrence is poor compared with those who have an isolated recurrent ovarian tumor. Grade 3 tumors (compared to grades 1/2) give rise to a higher rate of extraovarian recurrences.

  • Shvetha Zarek

    The careful follow up in this study in order to provide the most
    up-to-date outcomes for women who underwent fertility sparing surgery
    for EOC should be applauded. This paper provides useful clinical data
    when counseling patients who are interested in FSS. Do the authors have
    any data on how many of the patients who underwent FSS attempted to
    conceive and/or utilize oncofertility treatments?

  • Shvetha Zarek

    The careful follow up in this study in order to provide the most up-to-date outcomes for women who underwent fertility sparing surgery for EOC should be applauded. This paper provides useful clinical data when counseling patients who are interested in FSS. Do the authors have any data on how many of the patients who underwent FSS attempted to conceive and/or utilize oncofertility treatments?

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