Young women with early-stage ovarian cancer can preserve fertility by keeping at least one ovary or the uterus, without the risk of dying from the disease, according to the latest research.
Most cases of ovarian cancer are diagnosed at later stages and in older women. However, up to 17 percent of ovarian tumours occur in women 40 years or younger, many of whom have early stage disease.
Surgery for ovarian cancer usually involves complete removal of the uterus (hysterectomy) and ovaries and loss of fertility, but also subjects young women to the long-term consequences of oestrogen deprivation.
Researchers led by Jason Wright, of Columbia University College of Physicians (CUCPS) and Surgeons conducted a study to examine the safety of fertility-conserving surgery in pre-menopausal women with ovarian cancer.
This type of surgery conserves at least one ovary or the uterus.
The investigators analysed data from women 50 years or younger who were diagnosed with early stage (stage I) ovarian cancer between 1988 and 2004 and who were registered in the National Cancer Institute's Surveillance, Epidemiology and End Results database.
Patients who had both of their ovaries removed were compared with those who had only the cancerous ovary removed. A second analysis examined uterine conservation and hysterectomy.
For their first analysis, the researchers identified 1,186 ovarian cancer patients. While most had both ovaries removed, about one in three (36 percent) had one ovary conserved. They found those in whom one ovary was saved had similar survival for up to at least five years.
To examine the effect of uterine preservation, the investigators studied a total of 2,911 women. While most of the women underwent hysterectomy, about one in four (23 percent) had uterine preservation. Uterine preservation also had no effect on survival.
These results are promising for the many young women who are diagnosed with ovarian cancer each year.
The study is slated for publication in the September 15 issue of Cancer.