2022-RA-1640-ESGO Fertility-sparing treatment in patients with stage I ovarian dysgerminoma: an analysis of pregnancy outcomes. (20th October 2022) - Vicini, Debora
Abstract : Introduction/Background: To evaluate pregnancy outcomes in patients diagnosed with stage I ovarian dysgerminoma who underwent a fertility-sparing surgery in a tertiary-care center in Monza, Italy. Methodology: We performed a retrospective, observational study of women with a histologically confirmed diagnosis of ovarian dysgerminoma referred to our Institution from 1980 to 2020. We collected patients' characteristics, surgical procedures and postoperative management. Descriptive statistics were performed for baseline characteristics, while Fisher's exact test was used to investigate the association between type of surgery (ovarian cyst removal [CR] versus unilateral salpingo-oophorectomy [USO]), oncologic management (adjuvant chemotherapy [AC] versus follow-up [FU]) and pregnancy outcome. P<0.05 was considered significant. Results: Of 131 patients diagnosed with ovarian dysgerminoma, 49 were diagnosed withearly-stage disease, treated with fertility-sparing surgery and received follow-up at our Institution. During follow-up 18 patients never planned a pregnancy or had already completed childbearing while 31 patients tried to conceive, with a live birth rate of 96.7%. No differences in delivery rate were found either between patients managed with CR only (3/31) and with USO (28/31), or between patients who received AC after surgery (12/31) and those who received follow-up only (19/31). Six patients reached physiologic menopause: mean age at menopause was 51.7 years. Conclusion: Fertility-sparing surgical treatment is safe and feasible for patients with early-stage ovarian dysgerminoma. In our population, live birth rate was not affected by the type of surgery or postoperative oncologic management; the effect of fertility-sparing surgery for early-stage ovarian dysgerminoma on age at menopause should be further investigated.