Less Aggressive Ovarian Cancer Treatment Helps Preserve Fertility

Premenopausal women with stage one ovarian cancer who have the cancerous ovary removed have the same five-year survival rates as women who have both ovaries removed, according to a new study.

Researchers at Columbia University (New York, NY, USA) followed 1, 186 women aged 50 or under with stage 1A or 1C epithelial ovarian cancer, and compared 754 women (64%) who underwent bilateral oophorectomy with 432 women (36%) who underwent ovarian preservation; a second analysis examined uterine conservation versus hysterectomy. Multivariate Poisson regression models were developed to describe predictors of fertility preservation, and survival was examined using Cox proportional hazards models and the Kaplan-Meier method.

The results showed that younger age, later year of diagnosis, and residence in the eastern or western United States were associated with ovarian preservation. Women with endometrioid and clear cell histology and stage 1C disease were less likely to have ovarian conservation; the researchers also found that the preservation had no effect on survival. Young age, later year of diagnosis, residence in the eastern or western United States, single women, mucinous tumors, and patients with stage 1A disease were more likely to have uterine preservation; in this multivariate model, uterine preservation also had no effect on survival. The study was published ahead of print on August 10, 2009, in the online edition of the journal Cancer.

"Even if people have completed childbearing, there are some hormonal benefits for maintaining the ovaries. So this is something to consider in women 40 to 50,” said lead author Jason Wright, of the division of gynecologic oncology. "For example, some studies indicate that women who have their ovaries removed before age 55 have a higher risk for cardiovascular disease, dementia and earlier death.”

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