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Background: In epithelial ovarian cancer, conservative surgery has mainly been adopted for stage Ia disease, The aim of this study is to report on a conservative surgical approach used in selected young patients vith ovarian cancer who would usually undergo radical operations, Study Design: From 1980 through 1994, 10 patients with invasive epithelial ovarian cancer and with high-grade or limited extraovarian disease were treated with conservative surgery, The mean age was 22.7 years, The stage was Ia grade 3 in 2 patients, Ic in 2 patients, ma in 2 patients, and IIIc in 4 patients, Eight patients were given adjuvant therapy (radiotherapy in 1 and chemo-therapy in 7), Results: All patients were alive and disease-free at a median followup time of 70 months (range 24-138 months), Nine patients were menstruating regularly and three had become pregnant, Conclusions: It seems that in selected patients, conservative operations can be used beyond the worldwide accepted criterion of stage Ia, This concept deserves additional investigation in larger series. (C) 1997 by the American College of Surgeons).