Outcomes of fertility-sparing surgery in early-stage ovarian cancer; systematic review

Authors

  • Ziyad M. Alyami Consultant Gynecologic Oncology Minimally Invasive and Robotic Gynecologic Surgery, Department of Obstetrics and Gynecology, King Saud Medical City, women health hospital, Riyadh, Saudi Arabia Author
  • Wesam Abdulwasea Saeed AlMekhlafi Obstetrics & Gynecology consultant, Saudi Arabia Author
  • Abeer Othman Andarawi Associate consultant, King Saud Medical City, Riyadh, Saudi Arabia Author
  • Feras Ayman M Ghabashi Obstetrics & Gynecology Resident, King Saud Medical City, women health hospital, Riyadh, Saudi Arabia Author
  • Shima Basheer Ghulam Obstetrics and Gynecology resident, Ohud hospital, Madinah Al Munawwara, Saudi Arabia. Author
  • Norah Jazza Alsubaie Obstetrics and Gynecology resident, Riyadh First Cluster, King Saud Medical City, Women health hospital Author
  • Heba Jaffer Ali Alrebh Author
  • Razan Alharbi Obstetrics and Gynecology resident, ALQASSIM cluster, Saudi Arabia Author
  • Saad Khaleel Alonze Obstetrics And Gynecology Registrar, King Faisal Specialist Hospital & Research Centr, Riyadh, Kingdom of Saudi Arabia Author

DOI:

https://doi.org/10.65759/mcxtwy10

Keywords:

Fertility-sparing surgery, Early-stage ovarian cancer, Epithelial ovarian cancer, Reproductive outcomes, Oncologic outcomes

Abstract

Background: Fertility sparing surgery (FSS) is used in women with early-stage ovarian malignancies who aim to preserve fertility, but its oncologic safety still debated. Our review examined oncologic and reproductive outcomes after FSS. Methods: We conduct A PRISMA 2020-based systematic review in PubMed, Web of Science, Scopus, Embase, and the Cochrane Library from inception to early 2024. We include observational and registry-based analyses of reproductive-age women with early-stage epithelial ovarian cancer (EOC), malignant ovarian germ cell tumors (MOGCT), or sex cord-stromal tumors (SCST) treated with FSS. Primary outcomes were OS, disease-free survival, and recurrence; secondary outcomes were pregnancy, menstrual recovery, and live birth.  Results: We include 24 studies published between 2002 and 2024, mainly retrospective and included EOC, MOGCT, and SCST. In stage I EOC, large population-based studies showed no significant survival disadvantage with FSS, with 5-year overall survival above 95%. Recurrence after FSS ranged from 2.0% to 27.8%, with higher risk in grade 3 tumors, clear-cell carcinoma, and selected stage IC cases. In women attempting conception, pregnancy rates reached 91.2% in MOGCT and 92.3% in EOC, with live birth rates of 65% to 100% in those who conceived. Conclusion: FSS provide positive oncologic and reproductive outcomes in some women, although epithelial high-risk subgroups and SCST require special counseling and long surveillance.

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Published

2026-04-02

Issue

Vol. 3 No. 2 (2026): Journal of Tazeez for Public Health

Section

Articles