Oncological and reproductive outcomes of fertility-sparing surgery in young women with early-stage ovarian clear cell carcinoma: A retrospective cohort study
Fertility-sparing surgery for early-stage ovarian clear cell carcinoma (OCCC) remains controversial. In this study, we evaluated the oncological and reproductive outcomes of young patients with stage I OCCC who underwent fertility-sparing surgery. This retrospective cohort study included patients diagnosed with stage I OCCC treated at Peking Union Medical College Hospital between January 2010 and December 2020 who underwent surgical staging. Baseline demographics, surgical details, and outcomes were collected. Fertility-sparing surgery was defined as the preservation of the uterus, with or without the contralateral ovary. Progression-free and overall survival were estimated using the Kaplan-Meier method and compared using the log-rank test. Fifty-five patients were enrolled, of whom 21 underwent fertility-sparing surgery and 34 underwent radical surgery. Forty-four patients (80 %) were classified as stage IA/C1, while 11 (20 %) were classified as stage IC2/C3. There were no stage IB cases. After a median follow-up of 54 months (range: 5-117 months), recurrence occurred in one patient (4.6 %) in the fertility-sparing group and six patients (17.8 %) in the radical surgery group (p = 0.232). Three patients (5.4 %) in the radical surgery group died from disease progression. No significant differences were observed in 5-year progression-free survival (94.7 % vs. 78.8 %; p = 0.13) or 5-year overall survival (100 % vs. 87 %; p = 0.16) between the groups. Among six patients who attempted conception, two (33.3 %) achieved term pregnancies. Fertility-sparing surgery may be a viable option for young women with early-stage OCCC who wish to preserve fertility.