Prognostic factors and impact of fertility-sparing surgery in women with FIGO stage I clear cell ovarian carcinoma: a Surveillance, Epidemiology, and End Results (SEER) analysis

Purpose: This study aimed to investigate prognostic factors of stage I ovarian clear cell carcinoma (OCCC), as well as the impact of fertility-sparing surgery (FSS) on the oncologic outcomes of young patients with stage I ovarian clear cell carcinoma. Methods: : The Surveillance, Epidemiology, and End Results (SEER) database was accessed and data of patients with primary diagnosed stage I OCCC from 2010 to 2019 was extracted. Univariate and multivariate Cox regression analyses were employed to identify independent predictors associated with survival in women with stage I OCCC. Survival analysis was assessed with the Kaplan–Meier method, and the results were compared with the log-rank test. Results: : A total of 1,556 patients met the inclusion criteria. Median age was 56 years. The majority were unilateral (96.9%) and white (75.2%).1,213(78.0%) patients were treated with chemotherapy, and 1,271(81.7%) patients received Lymph node dissection. Age of diagnosis, race, and substage were independently associated with OS, while race, substage and months from diagnosis to treatment were independently associated with CSS. For OCCCs with stage IA, fertility-sparing surgery was not associated with a worse overall or cancer-specific survival. Chemotherapy and lymph node resection were not associated with survival outcomes of patients with stage IA who underwent FSS. Conclusions: : Overall LN dissection and chemotherapy did not significantly impact OS and CSS of women with FIGO stage I OCCC. Fertility-sparing surgery did not affect survival of stage IA OCCCs. Chemotherapy and LN dissection were not associated with survival outcome of patients with stage IA who underwent FSS.