A new study suggests conservative treatment for recurrent ovarian cancer may preserve a woman’s fertility, especially if cancer stubbornly returns in the reproductive organ. The presence of ovarian tumors can greatly reduce a woman’s ability to become pregnant, even if cancer remains in the early ‘Stage 1’ phase of the disease. The study shows that conservative treatment had a good overall survival rate and most recurrences of cancer remained at the non-invasive Stage 1 phase. If accurate, this discovery would be a significant breakthrough, as one-third of the women who develop these tumors are under the age of 40.
For this study, researchers looked at the outcomes of 26 women who suffered relapses following conservative treatment for Stage 1 ovarian cancer and who had undergone fertility-sparing surgeries. The scientists used ultrasound technology to confirm cancer’s return in these cases; 11 patients had relapsed at least twice after medical management.
Among the 26 study participants, 16 women wanted children. The scientists observed 21 pregnancies in 13 of the patients, with 17 pregnancies occurring spontaneously rather than through IVF. Eleven women had become pregnant after treatment for recurrent ovarian tumors.
Conservative Treatment versus Aggressive Treatment
Conservative treatment for early-stage ovarian tumors usually involves surgical removal of only one ovary and its fallopian tube. This procedure may preserve the woman’s ability to have children. The more aggressive approach is to remove both ovaries and fallopian tubes, the uterus, nearby lymph nodes, and a fold of fatty tissue known as the momentum, as ovarian cancer sometimes spreads there.
This study supports guidelines that favor a conservative approach to ovarian tumors. The researchers recommend fertility-saving surgeries whenever technically feasible in young patients with this type of cancer. However, scientists do strongly recommend these patients follow up with their doctors closely as these types of tumors may progress to a more serious phase of cancer.
- Catherine Uzan, Eve Muller, Aminata Kane, Sebastien Gouy, Sofiane Bendifallah, Raffaelle Fauvet, Emile Darai, and Philippe Morice. "Fertility-sparing treatment of recurrent stage I serous borderline ovarian tumors." Hum. Reprod. 2013 : det371v1-det371.