Pronostic et fertilité après traitement conservateur d'une tumeur ovarienne à la limite de la malignité: Revue d'une série continue de 68 cas

S. Camatte, R. Rouzier, J. Boccara-Dekeyser, P. Pautier, C. Pomel, C. Lhomme, P. Duvillard, D. Castaigne, P. Morice

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    Résumé

    The aim of this retrospective study was to evaluate the rate of recurrence and the reproductive outcome after surgical conservative treatment of low malignant ovarian tumors (LMOT). Material and methods - Sixty-eight patients with 50 Stage I LMOT and 18 LMOT with peritoneal implants treated conservatively at institut Gustave-Roussy, between January 1969 and December 2000. Fifty-nine patients had an unilateral adnexectomy (associated twelve times with a contralateral cystectomy), Seven had a bilateral cystectomy and two an unilateral cystectomy. Five patients recieved adjuvant therapy. Results - With a median follow-up of 71,5 months, 16 patients recurred and one had evolutive peritoneal disease. The histologic pattern of ovarian recurrences was always of borderline type. The histologic patterns of peritoneal recurrence was similar to those initially diagnosed except in one case. Peritoneal implants, exophytic tumor and serous type tumor were significatively associated with a higher 5-year recurrence rate. Recurrence was more frequent after cystectomy than unilateral adnexectomy (p = 0.13). None of patients treated conservatively recurred under the form of ovarian carciboma. None patient died of tumor. Nineteen patients experienced 26 pregnancies: 24 were spontaneous in a median delay of 19 months. Seven infertile patients underwent ovarian stimulation. None recurred after infertility treatments. The 2-yearand 5-year cumulative pregnancy rate were respectively 41,9 % and 59,8 %. Four patients experienced a pregnancy after a conservative treatment of their recurrence. Conclusion - Despite a high recurrence rate, especially in stage II and III serous LMOT, conservative treatment of LMOT does not affect survival and should be considered in young patients. Such treatment is not advised in case of invasive peritoneal implants. Spontaneous pregnancy rate is good but the frequent infertility associated with these tumors can afterwards require ovarian stimulation. Limited number of stimulation cycles is acceptable in such patients.

    Titre traduit de la contributionPrognosis and fertility results after conservative management of ovarian borderline tumors: Review of 68 cases
    langue originaleFrançais
    Pages (de - à)583-591
    Nombre de pages9
    journalGynecologie Obstetrique et Fertilite
    Volume30
    Numéro de publication7-8
    Les DOIs
    étatPublié - 1 janv. 2002

    mots-clés

    • Conservative treatment
    • Fertility
    • Low malignant ovarian tumor
    • Peritoneal implants

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