Survival similar for premenopausal women with stage 1 ovarian cancer treated with ovary and uterine conservation surgery compared to removal
A new study finds that young women with early-stage ovarian
cancer can preserve future fertility by keeping at least one ovary or the uterus
without increasing the risk of dying from the disease according to a study published
in the September 15, 2009 issue of Cancer, a peer-reviewed journal of the American
Cancer Society.
Researchers led by Jason Wright, M.D., of Columbia University
College of Physicians and Surgeons in New York City conducted a study to examine
the safety of fertility-conserving surgery in premenopausal women with ovarian
cancer. This type of surgery conserves at least one ovary or the uterus.
The investigators analyzed data from women 50 years of
age or younger who were diagnosed with stage I ovarian cancer between 1988 and
2004 and who were registered in the National Cancer Institute's Surveillance,
Epidemiology and End Results database, a population-based cancer registry that
includes approximately 26 percent of the US population. 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 vs. 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.
Women who were younger, who were diagnosed in more recent
years, and who resided in the eastern or western United States were more likely
to undergo ovarian or uterine conservation.
These results are promising for the many young women
who are diagnosed with ovarian cancer each year. An estimated 21,650 women in
the United States were diagnosed with the disease in 2008. "Given the potential
reproductive and nonreproductive benefits of ovarian and uterine preservation,
the benefits of conservative surgical management should be considered in young
women with ovarian cancer," the authors concluded.
The authors of the study are Jason D. Wright, Monjri
Shah, Leny Mathew, William M. Burke, Jennifer Culhane, Noah Goldman, Peter B.
Schiff, and Thomas J. Herzog.
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