Nonepithelial Ovarian Cancers: Surgical Procedures for Fertility Preservation
Posted: Monday, January 28, 2019
Fertility-sparing surgical procedures should be the optimal approach to patients with germ cell tumors, whereas for patients with sex cord stroll tumors, such fertility preservation procedures should be performed only in an early stage, according to a review of surgical approaches to treating nonepithelial ovarian cancers published in the Journal of Cancer. Nikolaos Thomakos, MD, PhD, of the University of Athens in Greece, and colleagues summarized data regarding fertility-sparing management and existing procedures while also accumulating data on the reproductive outcomes of patients who underwent such surgeries.
“It is important to highlight the encouraging results concerning fertility preservation and pregnancies achieved after conservative surgical approach of these patients,” the authors concluded. However, they noted, because of the rarity of nonepithelial ovarian cancers (estimated at about 10% of ovarian malignancies) and the relative newness of this strategy in gynecologic oncology, many aspects remain unclear and a universal consensus has not yet been achieved.
Although routine lymphadenectomy has not been introduced in international consensus as a routine procedure for treating germ cell tumors, it should at least be implemented in patients with dysgerminomas and mixed germ cell tumors. Regarding sex cord stroll tumors, existing data suggest against the implementation of pelvic lymphadenectomy as a routine procedure. In addition, despite strong recommendations for fertility preservation in patients with nonepithelial ovarian cancer, evidence concerning the reproductive function and fertility potential is unclear.
Disclosure: The study authors reported no conflicts of interest.