P0058 Preserving fertility in stage 1a ovarian carcinoma.

Background: This study assessed the role of fertility preserving surgery in the treatment of patients with stage 1a ovarian carcinoma, with or without chemotherapy. Methods: The study was done in NCI-Cairo University and El-Galaa Teaching Hospital from 2006 to 2011. 32 women younger than 35years, with histologically confirmed early ovarian carcinoma (FIGO stage 1a, G1, or G2), underwent fertility preserving resection for the treatment of their malignancies. Patients with borderline tumours were excluded from the study. Findings: Macroscopic unilateral tumuors were seen in 32 patients. Twenty-six (81%) patients had G1 tumours, among which 18 (69%) tumours were serous, six of 18 (30%) were mucinous, two (7.77%) were endometrioid, and none was clear cell type. Six (19%) patients had G2 tumours, all of which were serous cell type. The median follow up period was 48months. Two (6%) women were lost to follow up. Three (10%) women went for a second look operation after pregnancy, during cesarean section. All of them were free of any detectable disease. Two (7%) patients had abdominal exploration to investigate abnormal ultrasound finding. One patient with an invasive recurrence had completion to radical surgery with pelvic and para-aortic lymph node dissection, followed by adjuvant chemotherapy, and remained free of disease until the end of the follow up period. Another patient with a borderline tumour underwent ovarian cystectomy with ovarian preservation and continued her follow up period without further events. Since this patient had a borderline tumour, we regarded this study recurrence rate to be only one patient (3%), without any mortality. None of our patients had distant metastases. After treatment, only 18 of 30 (60%) women have recorded attempted conception, 12 of 18 (67%) had full term pregnancy, four of 18 (22%) had mid-trimestric abortion. All patients had normal conceptions and normal vaginal deliveries after full-term pregnancies. Interpretation: Fertility preserving surgery in stage 1a, G1, or G2 ovarian carcinoma can be considered proper treatment strategy in patients with this disease. [ABSTRACT FROM AUTHOR]