The aim of this study is to present our clinical experience about fertility-sparing procedures in early stage cervical cancer and its obstetrical and oncological outcomes. Between the years 2006 and 2016, a total of 22 early stage cervical cancer patients who underwent a fertility-sparing radical abdominal trachelectomy in our clinic were retrospectively analysed. The median age was 33 (range: 28–39) years. The median follow-up was 47 (range: 22–125) months. Five patients (22.7%) had Stage IA1, three patients had (13.6%) Stage IA2, and 14 patients (63.6%) had Stage IB1 disease. Only one patient had a recurrence. A pregnancy was obtained in five patients (22.7%) and one of them (20%) had a live birth. A pregnancy was obtained spontaneously in two patients (40%), whereas assisted reproductive techniques were used in three of the patients (60%). A miscarriage occurred in two patients (40%), and one of them was within the first trimester and the other was within the second trimester.
3 January 2021 in Archives of Gynecology and Obstetrics
We aimed to evaluate the factors associated with disease recurrence, recurrence patterns, and obstetric outcomes of borderline ovarian tumors (BOT). The primary outcome was to identify prognostic factors for disease recurrence-the secondary outcomes included recurrence sites and obstetric results. This study included patients diagnosed with BOT at Başkent University. Data were obtained from patient files and hospital records. Histopathological results were re-evaluated based on the new 2020 World Health Organization classification. Stage I or II disease is considered as early-stage disease, while stage III was deemed as advanced. Risk factors for disease recurrence were assessed for early-stage and advanced-stage diseases. Survival was measured from the time of diagnosis. A total of 142 patients were included with a median follow-up time of 100.5 (range: 20-266) months. Recurrence occurred in 24 (16.9 %) patients with a 5-year recurrence-free survival rate of 86.3 %, and no deaths recorded. The main site of tumor recurrence was the same ovary (12/24, 50 %). In multivariate analysis, cystectomy was identified as a risk factor for recurrence in the early stage (HR: 4.28; 95 % CI: 1.40-13.08, p = 0.011). The pregnancy rate was 76.7 % among 43 patients who attempted to conceive. There was no significant difference in obstetric outcomes between unilateral salpingo-oophorectomy (USO) and cystectomy (p = 0.223). The risk of recurrence in patients with BOT was higher in those who underwent cystectomy, while obstetric outcomes were similar between cystectomy and USO. Fertility-sparing surgery appears to be an appropriate choice for young women, offering satisfactory obstetric outcomes even in advanced-stage disease.