(Ivanhoe Newswire) -- Young women with early-stage ovarian cancer can
preserve fertility by keeping at least one ovary or the uterus without
increasing the risk of dying from the disease, a new study finds.
Although ovarian cancer occurs most often in older women, up to 17 percent of
ovarian tumors occur in women age 40 or younger, many of whom have early stage
disease. Surgery for ovarian cancer usually involves hysterectomy -- complete
removal of the uterus and ovaries -- which not only results in the loss of
fertility, but also subjects young women to long-term consequences of estrogen
deprivation.
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 early stage ovarian cancer between 1988 and 2004 and who were
registered in the National Cancer Institute's Surveillance, Epidemiology and End
Results database, a registry that includes approximately 26 percent of the U.S.
population. Patients who had both ovaries removed were compared with those who
had only the cancerous ovary removed. A second analysis examined uterine
conservation vs. hysterectomy.
Of the 1,186 ovarian cancer patients identified in the first analysis, about one
in three, or 36 percent, had one ovary conserved. The researchers found those in
whom one ovary was saved had similar survival for up to at least five years.
In the second analysis, researchers studied 2,911 women to investigate the
effect of uterine preservation. Of these women, about one in four, or 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. The study’s authors were quoted as saying, "Given the potential
reproductive and non-reproductive benefits of ovarian and uterine preservation,
the benefits of conservative surgical management should be considered in young
women with ovarian cancer."
SOURCE: Cancer, September 15, 2009
