旨在描述在美国接受保留生育手术的早期上皮性卵巢癌育龄患者的人群水平使用情况和结果。这项回顾性研究询问了国家癌症研究所的监测、流行病学和最终结果计划。该研究纳入了 3,027 名 50 岁以下的 I 期上皮性卵巢癌患者，这些患者在 2007 年至 2020 年期间接受了初次手术治疗。保留生育能力手术的定义是针对单侧病变保留一个卵巢和子宫，针对双侧病变保留子宫。 。通过对数变换的线性分段回归评估保留生育力手术的时间趋势。采用Cox比例风险回归模型评估与保留生育力手术相关的总生存率。共有534名患者（17.6%）接受了保留生育力手术。在队列水平上，2007 年保留生育手术的使用率为 13.4%，2020 年为 21.8%（趋势 P=0.009）。研究期间，非西班牙裔白人（2.8 倍）、具有高级浆液性组织学的个体（2.2 倍）和 IC 期疾病个体（2.3 倍）的保留生育手术利用率增加了两倍以上周期（趋势的所有 P<.05）。在控制了测量的临床病理特征后，接受保留生育手术的患者的总体生存率与接受非保留生育手术的患者相当（5年生存率93.6% vs 92.1%，调整后风险比0.87，95% CI，0.57-1.35 ）。这种生存相关性在高级别浆液性（5 年率 92.9% vs 92.4%）、低级别浆液性（100% vs 92.2%）、透明细胞（97.5% vs 86.1%）、粘液性（92.1% vs 86.6）中是一致的。 %）、低级别子宫内膜样组织（95.7% vs 97.7%）和混合组织学（93.3% vs 83.7%）（所有 P>.05）。在高级别子宫内膜样肿瘤中，保留生育能力的手术与总生存率降低相关（5 年生存率 71.9% vs 93.8%，调整后风险比 2.90，95% CI，1.09-7.67）。在双侧卵巢病变中，保留生育能力的手术与总生存率无关（5 年生存率分别为 95.8% 和 92.5%，P=.364）。研究期间，在 41,914 名患有任何年龄和分期的上皮性卵巢癌患者中，年龄小于 50 岁的 I 期疾病患者从 8.6% 增加至 10.9%（趋势 P=0.002）。近五分之一的生殖-近年来，美国的 I 期上皮性卵巢癌老年患者接受了保留生育能力的手术。除患有高级别子宫内膜样肿瘤的患者外，接受保留生育能力手术的 I 期上皮性卵巢癌育龄患者在 5 年时间点仍存活。版权所有 © 2024 美国妇产科学院妇科医生。由 Wolters Kluwer Health, Inc. 出版。保留所有权利。

To describe population-level utilization of fertility-sparing surgery and outcome of reproductive-aged patients with early epithelial ovarian cancer who underwent fertility-sparing surgery in the United States.This retrospective study queried the National Cancer Institute's Surveillance, Epidemiology, and End Result Program. The study included 3,027 patients younger than age 50 years with stage I epithelial ovarian cancer receiving primary surgical therapy from 2007 to 2020. Fertility-sparing surgery was defined as preservation of one ovary and the uterus for unilateral lesion and preservation of the uterus for bilateral lesions. Temporal trend of fertility-sparing surgery was assessed with linear segmented regression with log-transformation. Overall survival associated with fertility-sparing surgery was assessed with Cox proportional hazard regression model.A total of 534 patients (17.6%) underwent fertility-sparing surgery. At the cohort level, the utilization of fertility-sparing surgery was 13.4% in 2007 and 21.8% in 2020 (P for trend=.009). Non-Hispanic White individuals (2.8-fold), those with high-grade serous histology (2.2-fold), and individuals with stage IC disease (2.3-fold) had a more than twofold increase in fertility-sparing surgery utilization during the study period (all P for trend<.05). After controlling for the measured clinicopathologic characteristics, patients who received fertility-sparing surgery had overall survival comparable with that of patients who had nonsparing surgery (5-year rates 93.6% vs 92.1%, adjusted hazard ratio 0.87, 95% CI, 0.57-1.35). This survival association was consistent in high-grade serous (5-year rates 92.9% vs 92.4%), low-grade serous (100% vs 92.2%), clear cell (97.5% vs 86.1%), mucinous (92.1% vs 86.6%), low-grade endometrioid (95.7% vs 97.7%), and mixed (93.3% vs 83.7%) histology (all P>.05). In high-grade endometrioid tumor, fertility-sparing surgery was associated with decreased overall survival (5-year rates 71.9% vs 93.8%, adjusted hazard ratio 2.90, 95% CI, 1.09-7.67). Among bilateral ovarian lesions, fertility-sparing surgery was not associated with overall survival (5-year rates 95.8% vs 92.5%, P=.364). Among 41,914 patients who had epithelial ovarian cancer with any age and stage, those younger than age 50 years with stage I disease increased from 8.6% to 10.9% during the study period (P for trend=.002).Nearly one in five reproductive-aged patients with stage I epithelial ovarian cancer underwent fertility-sparing surgery in recent years in the United States. More than 90% of reproductive-aged patients with stage I epithelial ovarian cancer who underwent fertility-sparing surgery were alive at the 5-year timepoint, except for those with high-grade endometrioid tumors.Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.