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Background <p>Fertility-sparing surgery (FS) is a viable option for women with early-stage epithelial ovarian cancer (EOC) desiring fertility preservation. However, its oncological outcomes remain debated.</p> Methods <p>This retrospective cohort study analysed 135 patients with FIGO (International Federation of Gynaecology and Obstetrics) stage I EOC, operated between 1st January 2011 and 31st December 2020, comparing clinicopathological characteristics and oncologic outcomes between women who underwent FS (<i>n</i> = 26) and comprehensive staging surgery (CS) (<i>n</i> = 109). Continuous variables were compared using a <i>t</i>-test and Mann-Whitney test, while categorical variables were compared using the Chi-Square test. Disease-free and overall survival were plotted using Kaplan–Meier curves and compared using a log-rank test.</p> Results <p>During this period, Stage I EOC constituted 13.9% of the patients with EOC who underwent surgery. Patients in the FS group were younger (mean age 28.6 years versus 43 years, <i>p</i> = 0.00), with higher rates of nulliparity (77% versus 15%, <i>p</i> = 0.00). Though the pathological profile of the tumours in both groups was similar, 12(46%) in the FS group had high-grade histology. The FS group had a poorer follow-up rate (70% versus 83%, <i>p</i> = 0.033), a higher recurrence rate (30% vs. 8%, <i>p</i> = 0.001), and shorter mean disease-free survival (84.78 months vs. 124.86 months, <i>p</i> = 0.002). Older age and FS were significant predictors of recurrence at 2 and 5 years.</p> Conclusion <p>This study suggests that FS may be associated with higher recurrence rates in early-stage EOC. Careful patient selection, precise surgical information, and thorough follow-up protocols are crucial to balancing oncological safety with reproductive goals.</p>

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A Comparative Analysis of Fertility-Sparing Surgery and Complete Staging Surgery in Early Stage Epithelial Ovarian Cancer: Impact on Oncological Outcomes

  • 期刊论文

  • 发表日期：

    2025年9月3日

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  • Priyaroseni Briskala,
  • Vinotha Thomas,
  • Ajit Sebastian,
  • Reka Karuppusami,
  • Dhanya Susan Thomas,
  • Ashish Singh,
  • Sherin Daniel,
  • Rachel Chandy,
  • Anitha Thomas

摘要

Background

Fertility-sparing surgery (FS) is a viable option for women with early-stage epithelial ovarian cancer (EOC) desiring fertility preservation. However, its oncological outcomes remain debated.

Methods

This retrospective cohort study analysed 135 patients with FIGO (International Federation of Gynaecology and Obstetrics) stage I EOC, operated between 1st January 2011 and 31st December 2020, comparing clinicopathological characteristics and oncologic outcomes between women who underwent FS (n = 26) and comprehensive staging surgery (CS) (n = 109). Continuous variables were compared using a t-test and Mann-Whitney test, while categorical variables were compared using the Chi-Square test. Disease-free and overall survival were plotted using Kaplan–Meier curves and compared using a log-rank test.

Results

During this period, Stage I EOC constituted 13.9% of the patients with EOC who underwent surgery. Patients in the FS group were younger (mean age 28.6 years versus 43 years, p = 0.00), with higher rates of nulliparity (77% versus 15%, p = 0.00). Though the pathological profile of the tumours in both groups was similar, 12(46%) in the FS group had high-grade histology. The FS group had a poorer follow-up rate (70% versus 83%, p = 0.033), a higher recurrence rate (30% vs. 8%, p = 0.001), and shorter mean disease-free survival (84.78 months vs. 124.86 months, p = 0.002). Older age and FS were significant predictors of recurrence at 2 and 5 years.

Conclusion

This study suggests that FS may be associated with higher recurrence rates in early-stage EOC. Careful patient selection, precise surgical information, and thorough follow-up protocols are crucial to balancing oncological safety with reproductive goals.