Fertility-sparing surgery safe for those with early ovarian cancer

Young women with early-stage ovarian cancer can undergo fertility-preserving surgery without affecting the safety of their cancer treatment, according to research led by Sweden’s Karolinska Institutet.

Non-epithelial ovarian cancer (NEOC) is an unusual form of cancer most commonly diagnosed in young women. Fertility preservation is an important aspect of quality of life of young patients who undergo cancer therapy, so the standard treatment in the early stages of NEOC is fertility-sparing surgery, in which as much as possible of the reproductive organs is retained.

Researchers have now examined if there is any difference in survival rates between women who receive fertility-sparing surgery and women who undergo what is known as radical surgery, where the reproductive organs are removed completely. The results were published in the journal Gynecologic Oncology.

“This is the first prospective study investigating both the safety and efficacy of fertility-sparing surgery for treatment of NEOC in young women,” said the Karolinska Institutet’s Kenny Rodriguez-Wallberg, head researcher on the study.

Using data from the Swedish National Quality Registry for Gynecological Cancer, researchers analysed data from the entire population of women in Sweden between the ages of 18 and 40 who were diagnosed with early-stage (stage 1) NEOC from 2008 to 2015. The majority (78%) of the 73 women identified received fertility-sparing surgery.

To assay the oncological safety, the researchers compared the progression-free survival (survival without cancer relapse) and overall survival rates between women who received fertility-sparing surgery and women who received radical surgery. Fertility outcomes were examined through the Swedish Medical Birth Register and the Quality Registry for Assisted Reproductive Technology treatment.

The results show that there were no differences in survival rates between women who underwent fertility-sparing surgery and women who received radical surgery.

“The prognosis was excellent in both groups, with an overall survival of 98%,” said first author Gry Johansen, a doctoral student at the Karolinska Institutet. “After having undergone fertility-sparing surgery, 11 of the women gave birth to 13 babies, all conceived naturally.”

The study was a collaboration with the Regional Cancer Center West and the Sahlgrenska University Hospital. It was financed by the Swedish Cancer Society, the Cancer Research Funds of Radiumhemmet, Region Stockholm and the Karolinska Institutet.

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