Frequency of optimal and sub-optimal fertility-sparing surgery in young women with ovarian cancer: A single-center observational cohort study

Abstract

Objective: Ovarian cancer (OC) is the leading cause of death among young women across the globe. The gold standard treatment is cytoreduction surgery, which is always challenging due to fertility desires. The objective of this study was to determine the frequency of fertility-sparing surgery (FSS) in young patients with OC.

Methodology: A prospective observational cohort study was conducted at Indus Hospital and Health Network (IHHN), Karachi, Pakistan, from March 1, 2020, till June 30, 2024. This included women with diagnosed OC or epithelial borderline ovarian tumors (EBOT). The preoperative predictive scores of all women were evaluated, which indicated the best FSS outcomes.

Results: A total of 15 patients with OC were recruited, out of which 14 (93.3%) had optimal FSS, while one (6.7%) patient had suboptimal FSS. Our patients were categorized as follows: five (33.33%) had germ-cell ovarian tumor, four (26.66%) had sex cord-stromal tumor, three had EBOT, and three had epithelial ovarian cancer. There was an association between tumor markers LDH and AFP with optimal FSS outcomes.

Conclusions: Due to small sample size of our study, it is challenging to formulate a predictive model for optimal FSS. Hence, further prospective studies are required to design a predictive model for all types of OC.