부산대학교 도서관

Objective: We investigated the feasibility and safety of fertility-sparing surgery (FSS) inpatients with epithelial ovarian cancer (EOC) with dense adhesions. Methods: Patients were divided into cases with and without dense adhesions in thisretrospective study. Results: Of the 95 eligible patients, 29 patients had dense adhesions. Mean age, proportionof staging procedure, distribution of histologic type, and co-presence of endometriosis weredifferent (p=0.003, 0.033, 0.011, and 0.011, respectively). The median follow-up period was57.8 (0.4–230.0) months. There were no differences in the rates of recurrence (21.2% vs. 20.7%, p=1.000) or death (16.7% vs. 6.9%, p=0.332) between the 2 groups. There was nodifference in the pattern of recurrence or in disease-free survival (DFS) and overall survival(OS) between the 2 groups. In multivariate analysis, pretreatment cancer antigen-125 >35U/mL and International Federation of Gynecology and Obstetrics stage IC were significantfactors of worse DFS and OS, while dense adhesion was not a prognostic factor for both DFS(hazard ratio [HR]=0.9; 95% confidence interval [CI]=0.3–2.7; p=0.792) and OS (HR=0.2;95% CI=0.1–1.8; p=0.142), nor were age, proportion of staging procedure, histologic type, andco-presence of endometriosis. Moreover, the distribution of those 2 significant prognosticfactors was not different between the 2 groups. Dense adhesions were subgrouped into non tumor and tumor associated dense adhesions for further analysis and the results were same. Conclusion: FSS is feasible and safe in EOC, regardless of the presence of dense adhesions.