Fertility potential and safety assessment of residual ovarian cortex in young women diagnosed with epithelial borderline and early-stage malignant ovarian tumors
To establish the safety and quality of ovarian cortex surrounding epithelial ovarian tumors in women eligible for fertility-sparing surgery by identifying occult malignant lesions and characterizing the ovarian follicle pool. Multicentric retrospective study of 48 subjects (15–45 years), diagnosed w...
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| Veröffentlicht in: | Gynecologic oncology 2024-04, Vol.183, p.15-24 |
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| creator | Cacciottola, L. Camboni, A. Gatti, E. Marbaix, E. Vignali, M. Donnez, J. Dolmans, M.M. |
| description | To establish the safety and quality of ovarian cortex surrounding epithelial ovarian tumors in women eligible for fertility-sparing surgery by identifying occult malignant lesions and characterizing the ovarian follicle pool.
Multicentric retrospective study of 48 subjects (15–45 years), diagnosed with borderline ovarian tumors (BOTs) or early-stage epithelial ovarian cancers (EOCs) and eligible for fertility-sparing surgery. Histological samples of ovarian cortex surrounding tumors were analyzed to characterize the follicle pool, find any occult malignant lesion using tumor-specific markers (cytokeratin 7 and mucin 1), and quantify tumor-infiltrating lymphocytes (TILs) by CD3 and tumor associated macrophages (TAMs) by CD68.
Occult ovarian lesions were observed in 6 out of 45 cases investigated (14.6%), including one mucinous stage-I BOT (1/14), one serous stage-I BOT (1/13), 3 advanced-stage serous BOTs (3/11) and one early-stage serous EOC (1/7). Notably, follicle density was significantly lower in subjects diagnosed with ovarian tumors compared to controls (p |
| doi_str_mv | 10.1016/j.ygyno.2024.03.008 |
| format | Article |
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Multicentric retrospective study of 48 subjects (15–45 years), diagnosed with borderline ovarian tumors (BOTs) or early-stage epithelial ovarian cancers (EOCs) and eligible for fertility-sparing surgery. Histological samples of ovarian cortex surrounding tumors were analyzed to characterize the follicle pool, find any occult malignant lesion using tumor-specific markers (cytokeratin 7 and mucin 1), and quantify tumor-infiltrating lymphocytes (TILs) by CD3 and tumor associated macrophages (TAMs) by CD68.
Occult ovarian lesions were observed in 6 out of 45 cases investigated (14.6%), including one mucinous stage-I BOT (1/14), one serous stage-I BOT (1/13), 3 advanced-stage serous BOTs (3/11) and one early-stage serous EOC (1/7). Notably, follicle density was significantly lower in subjects diagnosed with ovarian tumors compared to controls (p < 0.001) and at a younger age. Significantly higher follicle atresia was encountered in the ovarian tumor group then in controls (20.1 ± 8.8% vs 9.2 ± 9.4%, p < 0.001) at all ages. Both TILs and TAMs were found in ovarian tumors irrespective of histotype, but no link was established with the status of the ovarian reserve.
Personalized counseling for fertility preservation is required in the event of BOTs and early-stage EOCs. Fertility-sparing surgery and adjuvant gamete preservation should be considered, balancing the oncological risks according to tumor stage and histotype and fertility potential, especially at a younger age.
•Epithelial ovarian tumors negatively affect the surrounding ovarian follicle pool by increasing follicle atresia.•The ovarian reserve is significantly impacted by ovarian lesions in the youngest patients.•Stage-I BOTs are at intermediate risk of occult lesions within healthy-looking ovarian cortex.•The oncological risk is as high as 27% in case of serous BOTs displaying pelvic implants.•Endometrioid ovarian tumors show low-risk oncological profile.</description><identifier>ISSN: 0090-8258</identifier><identifier>ISSN: 1095-6859</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2024.03.008</identifier><identifier>PMID: 38492474</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Borderline ovarian tumors ; Follicle atresia ; Oncofertility ; Ovarian follicle pool</subject><ispartof>Gynecologic oncology, 2024-04, Vol.183, p.15-24</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c309t-41e9d0b96ba052156b70b4a1dfea35f3a06ca9711cb97be4b04de3b53f23c46b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090825824001537$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38492474$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cacciottola, L.</creatorcontrib><creatorcontrib>Camboni, A.</creatorcontrib><creatorcontrib>Gatti, E.</creatorcontrib><creatorcontrib>Marbaix, E.</creatorcontrib><creatorcontrib>Vignali, M.</creatorcontrib><creatorcontrib>Donnez, J.</creatorcontrib><creatorcontrib>Dolmans, M.M.</creatorcontrib><title>Fertility potential and safety assessment of residual ovarian cortex in young women diagnosed with epithelial borderline and early-stage malignant ovarian tumors</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>To establish the safety and quality of ovarian cortex surrounding epithelial ovarian tumors in women eligible for fertility-sparing surgery by identifying occult malignant lesions and characterizing the ovarian follicle pool.
Multicentric retrospective study of 48 subjects (15–45 years), diagnosed with borderline ovarian tumors (BOTs) or early-stage epithelial ovarian cancers (EOCs) and eligible for fertility-sparing surgery. Histological samples of ovarian cortex surrounding tumors were analyzed to characterize the follicle pool, find any occult malignant lesion using tumor-specific markers (cytokeratin 7 and mucin 1), and quantify tumor-infiltrating lymphocytes (TILs) by CD3 and tumor associated macrophages (TAMs) by CD68.
Occult ovarian lesions were observed in 6 out of 45 cases investigated (14.6%), including one mucinous stage-I BOT (1/14), one serous stage-I BOT (1/13), 3 advanced-stage serous BOTs (3/11) and one early-stage serous EOC (1/7). Notably, follicle density was significantly lower in subjects diagnosed with ovarian tumors compared to controls (p < 0.001) and at a younger age. Significantly higher follicle atresia was encountered in the ovarian tumor group then in controls (20.1 ± 8.8% vs 9.2 ± 9.4%, p < 0.001) at all ages. Both TILs and TAMs were found in ovarian tumors irrespective of histotype, but no link was established with the status of the ovarian reserve.
Personalized counseling for fertility preservation is required in the event of BOTs and early-stage EOCs. Fertility-sparing surgery and adjuvant gamete preservation should be considered, balancing the oncological risks according to tumor stage and histotype and fertility potential, especially at a younger age.
•Epithelial ovarian tumors negatively affect the surrounding ovarian follicle pool by increasing follicle atresia.•The ovarian reserve is significantly impacted by ovarian lesions in the youngest patients.•Stage-I BOTs are at intermediate risk of occult lesions within healthy-looking ovarian cortex.•The oncological risk is as high as 27% in case of serous BOTs displaying pelvic implants.•Endometrioid ovarian tumors show low-risk oncological profile.</description><subject>Borderline ovarian tumors</subject><subject>Follicle atresia</subject><subject>Oncofertility</subject><subject>Ovarian follicle pool</subject><issn>0090-8258</issn><issn>1095-6859</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAURi0EokPhCZCQl2wSruMkEy9YoIoCUiU2sLb8cxM8SuzBdlryOLwpns7Ako0t2ed-n64OIa8Z1AxY_-5Qb9PmQ91A09bAa4DhCdkxEF3VD514SnYAAqqh6YYr8iKlAwBwYM1zcsWHVjTtvt2R37cYs5td3ugxZPTZqZkqb2lSI5ZHlRKmtJQPGkYaMTm7FiLcq-iUpybEjL-o83QLq5_oQygotU5NPiS09MHlHxSP5cT5lKxDtBhn5_GxBFWctyplNSFd1Owmr05Fl_C8LiGml-TZqOaEry73Nfl--_Hbzefq7uunLzcf7irDQeSqZSgsaNFrBV3Dul7vQbeK2REV70auoDdK7BkzWuw1thpai1x3fGy4aXvNr8nbc-4xhp8rpiwXlwzOs_IY1iQb0Q2NYMMeCsrPqIkhpYijPEa3qLhJBvLkRh7koxt5ciOBy-KmTL25FKx6Qftv5q-MArw_A1jWvHcYZTIOvUHrIposbXD_LfgD9pymuA</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Cacciottola, L.</creator><creator>Camboni, A.</creator><creator>Gatti, E.</creator><creator>Marbaix, E.</creator><creator>Vignali, M.</creator><creator>Donnez, J.</creator><creator>Dolmans, M.M.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240401</creationdate><title>Fertility potential and safety assessment of residual ovarian cortex in young women diagnosed with epithelial borderline and early-stage malignant ovarian tumors</title><author>Cacciottola, L. ; Camboni, A. ; Gatti, E. ; Marbaix, E. ; Vignali, M. ; Donnez, J. ; Dolmans, M.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c309t-41e9d0b96ba052156b70b4a1dfea35f3a06ca9711cb97be4b04de3b53f23c46b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Borderline ovarian tumors</topic><topic>Follicle atresia</topic><topic>Oncofertility</topic><topic>Ovarian follicle pool</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cacciottola, L.</creatorcontrib><creatorcontrib>Camboni, A.</creatorcontrib><creatorcontrib>Gatti, E.</creatorcontrib><creatorcontrib>Marbaix, E.</creatorcontrib><creatorcontrib>Vignali, M.</creatorcontrib><creatorcontrib>Donnez, J.</creatorcontrib><creatorcontrib>Dolmans, M.M.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cacciottola, L.</au><au>Camboni, A.</au><au>Gatti, E.</au><au>Marbaix, E.</au><au>Vignali, M.</au><au>Donnez, J.</au><au>Dolmans, M.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fertility potential and safety assessment of residual ovarian cortex in young women diagnosed with epithelial borderline and early-stage malignant ovarian tumors</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>183</volume><spage>15</spage><epage>24</epage><pages>15-24</pages><issn>0090-8258</issn><issn>1095-6859</issn><eissn>1095-6859</eissn><abstract>To establish the safety and quality of ovarian cortex surrounding epithelial ovarian tumors in women eligible for fertility-sparing surgery by identifying occult malignant lesions and characterizing the ovarian follicle pool.
Multicentric retrospective study of 48 subjects (15–45 years), diagnosed with borderline ovarian tumors (BOTs) or early-stage epithelial ovarian cancers (EOCs) and eligible for fertility-sparing surgery. Histological samples of ovarian cortex surrounding tumors were analyzed to characterize the follicle pool, find any occult malignant lesion using tumor-specific markers (cytokeratin 7 and mucin 1), and quantify tumor-infiltrating lymphocytes (TILs) by CD3 and tumor associated macrophages (TAMs) by CD68.
Occult ovarian lesions were observed in 6 out of 45 cases investigated (14.6%), including one mucinous stage-I BOT (1/14), one serous stage-I BOT (1/13), 3 advanced-stage serous BOTs (3/11) and one early-stage serous EOC (1/7). Notably, follicle density was significantly lower in subjects diagnosed with ovarian tumors compared to controls (p < 0.001) and at a younger age. Significantly higher follicle atresia was encountered in the ovarian tumor group then in controls (20.1 ± 8.8% vs 9.2 ± 9.4%, p < 0.001) at all ages. Both TILs and TAMs were found in ovarian tumors irrespective of histotype, but no link was established with the status of the ovarian reserve.
Personalized counseling for fertility preservation is required in the event of BOTs and early-stage EOCs. Fertility-sparing surgery and adjuvant gamete preservation should be considered, balancing the oncological risks according to tumor stage and histotype and fertility potential, especially at a younger age.
•Epithelial ovarian tumors negatively affect the surrounding ovarian follicle pool by increasing follicle atresia.•The ovarian reserve is significantly impacted by ovarian lesions in the youngest patients.•Stage-I BOTs are at intermediate risk of occult lesions within healthy-looking ovarian cortex.•The oncological risk is as high as 27% in case of serous BOTs displaying pelvic implants.•Endometrioid ovarian tumors show low-risk oncological profile.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38492474</pmid><doi>10.1016/j.ygyno.2024.03.008</doi><tpages>10</tpages></addata></record> |
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| subjects | Borderline ovarian tumors Follicle atresia Oncofertility Ovarian follicle pool |
| title | Fertility potential and safety assessment of residual ovarian cortex in young women diagnosed with epithelial borderline and early-stage malignant ovarian tumors |
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