Mucinous carcinoma recurrence after fertility preservation surgery

Abstract

Benign ovarian tumours occurs in 7% of women in reproductive age group. The average age of onset for borderline ovarian tumours is ten years younger than that of ovarian cancers. Considered the very good prognosis following an adequate surgical staging in early epithelial ovarian cancers (EOCs), the FPS for women of childbearing age group has become an argument of debate in last decades. 25% of the EOCs are diagnosed in early stages, 14% of those early stage patients are under age of 40 at the time of diagnosis. Fertility preservation is widely accepted in early stage epithelial ovarian cancers, germ cell, sex cord stromal tumours. Based on data, fertility sparing surgery in EOCs recommended in stage 1A, grade 1 and 2 and favourable histologic types (endometrioid, mucinous, low grade serous and clear cell carcinomas) ovarian cancer. Above stage 1A, grade 3, high grade serous and clear cell tumours decision process about FPS should be individualised, weighing a slightly higher risk of recurrence with fertility goals. Correct surgical staging is mandatory and oncological safety should be primary importance. Survival rates in oncological patients have been steadily increasing now a days due to the effectiveness of novel oncological treatments like surgery, chemo and radiotherapy. However, these treatments impair the reproductive ability of the patients and may cause premature ovarian failure in females and azoospermia in males. A multidisciplinary approach with oncology, reproductive endocrinology may be of utility to help these patients to achieve their fertility goals in future.