Young Early-Stage Ovarian Cancer Patients Can Preserve Fertility, New study suggest

A new study has found that young women in the early stages of ovarian cancer may be successfully treated for the disease without losing their healthy uterus or ovary. The results of the study will appear in the Sept. 15, 2009 issue of the journal Cancer, published by the American Cancer Society.

The study, led by Jason Wright, Levine Family Assistant Professor of Women's Health at Columbia’s College of Physicians and Surgeons, compared data of ovarian cancer patients who had both ovaries removed to women who removed only the cancerous ovary. The researchers found that patients who kept an ovary had a similar five-year survival rate to those who removed both ovaries. The study also analyzed patients who kept their uterus, as opposed to those who underwent hysterectomy, and found that uterine preservation did not negatively affect survival rates.

The treatment of ovarian cancer often involves complete removal of the uterus and both ovaries, which leads to menopause and exposes young women to the risks of long-term estrogen deprivation. Most cases of ovarian cancer occur in women over the age of 40 and are detected when the cancer is in an advanced stage, but up to 17 percent of ovarian cancers are found among women 40 years old or younger, many of whom are in the early stages of disease.

The study analyzed data from women 50 years old or younger who had been diagnosed with stage 1 ovarian cancer between 1988 and 2004. In one analysis, researchers studied 1,286 ovarian cancer patients and found that most patients had both ovaries removed—only 36 percent of the patients kept an ovary. A second analysis studied 2,911 women for uterine preservation. Among the women studied, the majority underwent a hysterectomy; only 23 kept their uterus.

“This represents the largest study of ovarian and uterine-conserving surgery for early-stage ovarian cancer,” said Dr. Wright.

The results of the study are promising for the many young women who are diagnosed with ovarian cancer each year and, according to Dr. Wright, “warrant additional studies of conservative surgery for young women with epithelial ovarian cancer.” An estimated 21,650 women in the United States were diagnosed with the disease in 2008.

“For young women with early-stage ovarian cancer, fertility-conserving surgery may be a reasonable alternative,” said Dr. Wright. “It is important for women to discuss the risks and benefits of fertility-preserving procedures with their physicians.”

A research from Columbia University , 14 August 2009

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