Oncological safety of fertility preservation treatment in ovarian cancer: A Spanish multicenter study

Abstract Objective To assess the safety of fertility‐sparing treatments for early‐stage ovarian cancer in women younger than 40 years old. Methods We performed a retrospective multicenter study including women aged 18–40 years diagnosed with early‐stage (FIGO I–II) ovarian cancer in 55 Spanish hospitals, from January 2010 to December 2019. Benign and borderline tumors were excluded, as well as advanced stages (FIGO III–IV). All perioperative characteristics and follow‐up data were collected and analyzed. Standard staging surgery (SSS) was compared with fertility‐sparing surgery (FSS) in terms of oncological outcomes. Results In all, 366 women were included; 327 (89.3%) were stage I. Among all patients, 216 (59%) underwent SSS and 150 (41%) FSS. Up to 208 (56.8%) patients did not have children, but only 12 (3.2%) had oocyte preservation before treatment. Patients in the FSS group compared with the SSS group showed a non‐significant difference in recurrences (8% vs. 9.3%, respectively; P < 0.711) and deaths (1.3% vs. 4.8%, respectively; P = 0.211) during the follow‐up. No significant differences were found between epithelial and non‐epithelial ovarian cancer both in recurrences (7.1% vs. 8.8%, respectively; P = 0.771) and in deaths (1.4% vs. 1.3%, respectively; P = 1) among patients who underwent FSS. Conclusion FSS seems a safe option for treatment of early‐stage ovarian cancer in patients who want to preserve fertility, either for epithelial and non‐epithelial histology.