A new policy regarding ovarian resection in young women treated for peritoneal carcinomatosis.

Abstract:

OBJECTIVE:To appreciate if the ovaries can be preserved in selected young women with peritoneal carcinomatosis (PC). BACKGROUND:The traditional rule is to resect the ovaries systematically when PC is found at surgery. METHODS:A new policy was developed to preserve the ovaries when they were macroscopically normal in young women with PC of different origin who expressed a strong desire for future pregnancy. RESULTS:A total of 106 women younger than age 41 years underwent complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. At least one ovary was preserved in 29 % of them (and in 44 % of those who strongly wished future pregnancy). Among resected "normal" ovaries, 17 % were involved by tumor at the final pathologic examination. Among the resected "suspicious" ovaries, 38 % were involved. Among the 29 preserved ovaries (in 21 women), after a median follow-up of 32 months, 4 (14 %) developed ovarian recurrence, in 3 of them associated with other metastases. Two women became pregnant. In five women with partially normal ovary, egg harvesting and cryopreservation was performed. CONCLUSIONS:This new policy allowed ovarian preservation in 44 % of the young women wishing childbearing and allowed two births. Recurrence in the preserved ovary was 14 % with our criteria of selection. This policy is promising but can be further improved.

journal_name

Ann Surg Oncol

authors

Elias D,Duchalais E,Dartigues P,Duvillard P,Poirot C,Goéré D

doi

10.1245/s10434-013-2879-8

subject

Has Abstract

pub_date

2013-06-01 00:00:00

pages

1837-42

issue

6

eissn

1068-9265

issn

1534-4681

journal_volume

20

pub_type

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