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Table 2 Fertility-sparing interventions in women with borderline ovarian tumors or ovarian cancer

From: Fertility preservation in women with cervical, endometrial or ovarian cancers

Diagnosis Type of Surgery Description Reproductive and Obstetric Outcomes Oncologic Outcome Quality of Life
Borderline Ovarian Tumor FIGO Stage Ia Unilateral oophorectomy/bilateral cystectomy Removing the affected ovary only, keeping in place the unaffected one and the uterus Spontaneous pregnancies have been reported with favorable obstetric outcome [99] Higher recurrence rates in fertility-sparing surgery compared with radical surgery, with no difference in mortality [97, 98]. Recurrence 0 %–20 % versus 12 %–58 % when only cystectomy was performed [6] High quality of life and higher sexual satisfaction scores after fertility-sparing surgery [103]
Borderline Ovarian Tumor FIGO Stages Ic–III Unilateral oophorectomy/bilateral cystectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy, omentectomy Removing the affected ovary only, thorough oncological staging Pregnancy rate of 86 %, more than half of the patients required fertility treatment [99] No difference in recurrence or survival compared with radical surgery removing both ovaries and the uterus [6, 99]. Lack of data
Ovarian Epithelial Cancer FIGO Stage IA, grade 1 Unilateral oophorectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy and omentectomy Removing the affected ovary only, thorough oncological staging Pregnancy rates of >60 % Pregnancies have been reported with favorable obstetric outcome [145] 5-year survival 87 %, recurrence 7–12 % [6, 17] No difference in quality of life aspects or sexual satisfaction scores compared with radical surgery [46]
Ovarian Epithelial Cancer – FIGO Stage IA, grade 2–3 or Clear Cell Carcinoma Unilateral oophorectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy, omentectomy and adjuvant chemotherapy Removing the affected ovary only, thorough oncological staging
Adjuvant platinum-based chemotherapy
Pregnancy rate of 80 % with live-birth rate of 65 % in women presenting with cancer grades 1–3. Higher number of women with cancer grades 1–2 attempting pregnancy in comparison with women with grade 3 cancers [87] No difference in recurrence or survival compared with radical surgery [86] Lack of data
Malignant Germ Cell Cancers grade I Unilateral oophorectomy, peritoneal staging, omentectomy, pelvic & para-aortic lymphadenectomy and adjuvant chemotherapy Removing the affected ovary only, adjuvant BEP chemotherapy has been recommended, or expectant management 76 % pregnancy rate. Pregnancies have been reported with favorable obstetric outcome [147, 148] Fertility-sparing surgery has not been associated with impaired oncological outcome [108] Good quality of life reported with good psychological health and sexual function [129]
  1. Modified from: Rodriguez-Wallberg KA, Oktay K. Fertility preservation during cancer treatment: clinical guidelines. Cancer management and research. 2014;6:105-17
  2. Abbreviations: FIGO International Federation of Gynecology and Obstetrics, BEP bleomycin, etoposide and cisplatin