The demand for fertility-sparing surgery (FSS) has increased in the last decade due to
increased maternal age, increased incidence of ovarian malignancies in younger patients, and technical advances in surgery. Data on oncological safety and fertility outcomes of patients with ovarian
cancer after laparoscopic FSS are sparse, but some retrospective studies have shown that open FSS
may be offered to selected patients. We assessed the role of minimally invasive FSS in comparison
with radical surgery (RS) in terms of oncological safety and reproductive outcomes after FSS in this
multicenter study. Eighty patients with FIGO stage I/II ovarian cancer treated with laparoscopic
FSS or RS between 01/2000 and 10/2018 at the participating centers (comprehensive gynecological
cancer centers with minimally invasive surgical expertise) were included in this retrospective analysis
of prospectively kept data. Case–control (n = 40 each) matching according to the FIGO stage was
performed. Progression-free survival [150 (3–150) and 150 (5–150) months; p = 0.61] and overall
survival [36 (3–150) and 50 (1–275) months; p = 0.65] did not differ between the FSS and RS groups.
Eight (25.8%) women became pregnant after FSS, resulting in seven (22.5%) deliveries; three (37.5%)
patients conceived after in vitro fertilization, and five (62.5%) conceived spontaneously. Laparoscopic
FSS seems to be applicable and oncologically safe for patients with early-stage ovarian cancer, with
adequate fertility outcomes