Is surgical restaging indicated in apparent stage IA pure XXXX ? The MITO group retrospective experience.

@entity43 @entity1 @entity444 @entity902
OBJECTIVE: Conservative surgery followed by @entity902 -based chemotherapy is considered the standard approach for pure @entity43 (POD), except for correctly staged IA @entity1 . The aim of study was to evaluate the outcome of IA POD @entity1 with incomplete surgical staging in order to define the proper management. METHODS: Data concerning primary treatment and recurrence were reviewed for 26 @entity1 with stage IA POD treated in MITO (Multicenter Italian Trials in @entity43 ) centers. RESULTS: Median age was 22.5years. Primary surgery was fertility sparing for 17 @entity1 (65.4%) and radical surgery was performed in 9 @entity1 due to older age or @entity444 . Only five @entity1 (19.2%) had complete surgical staging; 38.5% had lymph node dissection, 46.2% had peritoneal biopsies and/or omentectomy and 65.4% had peritoneal washing. Seven @entity1 received adjuvant chemotherapy. Overall recurrence rate was 11.5%: all recurrences occurred in the group submitted to incomplete staging procedure. No @entity1 treated with adjuvant chemotherapy relapsed. One @entity1 had pelvic recurrence, one @entity1 relapsed in the abdomino-pelvic peritoneum and lymph nodes and the third @entity1 showed a peritoneum, lymph nodal and residual ovary relapse. All @entity1 with recurrence were cured by salvage therapy: 2 @entity1 were treated with surgery plus chemotherapy and one only with chemotherapy. After a median follow-up of 100months all @entity1 are alive without evidence of disease. Six @entity1 opted for conception and delivered healthy @entity1 , two with IVF with donor oocyte. CONCLUSIONS: IA POD prognosis is excellent. Conservative surgery with a complete surgical staging is the gold standard. @entity1 with incomplete staging could undergo surgical restaging or surveillance. Chemotherapy should be reserved to relapse with excellent chances of therapeutic success.
