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GO-10 : Poor prognosis after conservative surgery in stage I mucinous epithelial ovarian cancer
( Phill Seung Jung ),( Shin Wha Lee ),( Jeong Yeol Park ),( Dai Shik Suh ),( Dae Yeon Kim ),( Jong Hyeok Kim ),( Yong Man Kim ),( Young Tak Kim ),( Joo Hyun Nam ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-
목적: To evaluate the oncologic safety and to identify prognostic factor for recurrence in premenopausal women with stage I mucinous epithelial ovarian cancer (mEOC) who underwent conservative surgery. 방법: We enrolled 97 patients who were 1) premenopausal at the time of surgery and 2) confirmed to be the FIGO stage I. The surgical procedure of conservative surgery was unilateral salpingo-oophorectomy with/without contralateral ovarian wedge resection. 결과: The median age was 33 (range: 13-50) years at the time of surgery. Sixty-three (64.9%) patients were stage Ia, and 34 (35.1%) were Ic. Fifty-three (54.6%) patients underwent conservative surgery, and adjuvant chemotherapy was administrated to 61 (62.9%) patients. During 73.7 (range: 7.1-243.5) months of the median follow-up duration, 13 (13.4%) patients recurred and 8 (8.2%) of them died of disease. Among patients who underwent conservative surgery, there were 10 recurrences and the majority of recurred site was intraperitoneal cavity (n=8) with median age of 25 (range: 14-46) and median PFS of 17.8 (range: 5.1-53.3) months. In multivariate analysis, a significantly poorer prognosis was noted in patients who underwent conservative surgery (HR: 6.26, 95% CI: 1.53-25.53, p=0.011) and in patients with high preoperative CA-125 (HR: 1.98, 95% CI: 1.26-3.11, p=0.003). In patients with high preoperative CA-125 (>35U/mL, n=48), conservative surgery caused significantly higher recurrence rate (HR: 5.73, 95% CI: 1.22-27.03, p=0.027). 5-year disease-free survival rate was significantly lower in patients who underwent conservative surgery than in patients who did not (77.7% vs. 94.2%, p=0.047). 결론: In conclusion, conservative surgery might cause the poor prognosis in premenopausal women with stage I mEOCs, particularly with high preoperative CA-125 level. The further multicenter study with larger cohort would be needed to verify the oncologic safety of conservative surgery in mEOCs.