Data Availability StatementPlease contact the corresponding author for data requests. TSS times were estimated using the Kaplan-Meier model and compared between the groups using the log-rank test. The Cox regression model was used for multivariate analysis. Variables with values reported were two tailed; values? ?0.05 were considered statistically significant. We performed statistical analyses using IBM SPSS 22.0 software for Macintosh and Graph Pad Prism 5.0. Results Study population A review of the database revealed 144 patients with stage I EOC aged ?40?years at diagnosis during the study period (1999C2013). Overall, 108 patients met the inclusion criteria and were included in the analysis. The selection process and reasons for patient exclusion are summarized in Fig. ?Fig.1.1. Eleven patients with high-risk disease wanted to preserve their fertility and underwent FSS. Altogether, AZD8055 distributor 52 (48.1%) patients underwent FSS and 56 (51.9%), RS. Open in a separate window Fig. 1 Patient enrollment Comparison of clinical and pathological features Clinical and pathological variables are shown in Table ?Table1.1. The median age of patients at diagnosis who underwent FSS was significantly younger (by 10?years), compared with those who underwent RS (valueradical surgery, fertility-sparing surgery, laparoscopy, laparotomy, epithelial ovarian cancer, clear-cell carcinoma, endometriosis-associated ovarian cancer, endometrial carcinoma Comparison of oncologic outcomes After a median follow-up of 83?months (range, 9C216?months), 14 (13.0%) patients relapsed, 8 (7.4%) died of progressive disease, and 100 (92.6%) were censored in the entire study cohort. The 5-12 months TSS and DFS rates were 92.6 and 86.6%, respectively. RS and FSS patients had a 5-12 months TSS rate of 89.3 and 97.3%, respectively, and a 5-year DFS rate of 83.0 and 91.0%, respectively. Tables ?Tables22 and ?and33 show the results of the univariate and multivariate survival analyses of DFS and TSS, respectively. Surgery type, age, tumor size, histology, tumor grade, FIGO sub-stage, pretreatment tumor markers, and EAOC were included in the univariate analysis. Patients with grade AZD8055 distributor 1-2 tumor tended to have higher 5-12 months DFS (valuea valueb radical surgery, fertility-sparing surgery, epithelial ovarian cancer, clear-cell carcinoma, endometriosis-associated ovarian cancer, disease-free survival, confidence intervals aLog-rank test bCox proportional hazards model Table 3 Risk factors related to TSS in stage I EOC patients of reproductive age valuea valueb radical surgery, fertility-sparing surgery, tumor-specific survival, epithelial ovarian cancer, clear-cell carcinoma, endometriosis-associated ovarian Rabbit polyclonal to ZNF346 cancer, dead of the recorded disease, hazard ratios, confidence intervals aLog-rank test bCox proportional hazards model Open in a separate windows Fig. 2 Comparison of survival in women of reproductive age with stage I epithelial ovarian cancer. Kaplan-Meier survival curves showing the effect of FSS or RS on disease-free survival (a) (valueclear-cell carcinoma, radical surgery, fertility-sparing surgery Comparison of pattern of recurrence As can be seen from Table ?Table5,5, 22.2% (2/9) in the RS group versus 80.0% (4/5) in FSS had localized relapses. In the FSS group, 80.0% of recurrences were confined to the contralateral ovary. Furthermore, 71.4% (5/7) in grade 1-2 versus 14.3% (1/7) in grade AZD8055 distributor 3/CCC had localized relapses. Desk 5 Design of oncologic and recurrence final results from the relapsed sufferers radical medical procedures, fertility-sparing medical procedures, clear-cell carcinoma, relapse-free intervals, useless of the documented disease, no proof disease, alive using the documented disease, re-cytoreductive medical procedures, high-grade serous carcinoma, tumor-specific survival Four in five FSS patients AZD8055 distributor had a localized relapse in the contralateral ovary; the remaining patient had a disseminated relapse in the lung. Most patients in the RS group had multiple relapse sites and lost AZD8055 distributor the opportunity to undergo follow-up surgery. Taking a closer look at outcomes, seven (77.8%) of nine patients in the RS group had relapses and one (20.0%) of five patients in the FSS group who.