Journal of Clinical and Investigative Surgery
ISSN: 2559-5555


Fertility sparing surgery for stage Ic ovarian cancer: An eight case series

Montassar Ghalleb1,2, Hatem Bouzaiene1,2, Sarah Seghaier1,2, Hanen Bouaziz1,2, Monia Hechiche1,2, Riadh Chargui1,2, Rahal Khaled1,2

1Institute Salah Azaiez of Oncology Tunis, Department of Surgical Oncology, Tunisia
2Faculty of Medicine of Tunis, University Tunis el Manar

J Clin Invest Surg. 2019; 4(1): 32-37. DOI: 10.25083/2559.5555/4.1/32.37
Running title: Fertility sparing surgery for stage Ic ovarian cancer
Keywords: ovarian cancer, stage IC, surgery, fertility


Introduction. One case out of 3 cases of primary ovarian cancer is diagnosed at an early stage. Almost 15% of ovarian cancers are diagnosed in women who are within the range of procreation age, raising the debate on the feasibility of fertility-sparing surgery (FSS) for those tumors. In the case the patient is admitted with stage 1A or 1B in most histologic types, it is still controversial in stage 1C.

Results and Discussions. This is an eight-patient-case series. The median age is 27 years old (ranging from 18 to 42). The main clinical manifestation was pelvic pain (87.5%). Four patients (50%) presented with tumor torsion. All patients underwent FSS; five of them (62.5%) had conservative staging, two (25%) underwent salpingo-oophorectomy and one (12.5%) ovariectomy, type histo + stade Figo. The chemotherapeutic treatment was administered to four patients (50%) following surgery without major side effects. One patient (12.5%) presented a loco regional recurrence that occurred 14 months later. She was treated with combined chemotherapy and radical surgery. One patient out of eight (12.5%) achieved a natural pregnancy after the treatment and another one (12.5%) was submitted to an assisted reproductive procedure which did not result in a viable pregnancy.

Conclusion. FSS seems to be a suitable approach for stage 1C ovarian cancer. However, more case series and meta-analyses should be conducted.