ADOLESCENT AND PEDIATRIC GYNECOLOGY: Edited by Roshi M. ZinnOvarian conservation in management of pediatric gynecology malignanciesStambough, Kathryna; Childress, Krista J.b,cAuthor Information aDivision of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas bDivision of Gynecologic Specialties, Pediatric and Adolescent Gynecology, Department of Gynecology and Obstetrics, Emory University School of Medicine cDivision of Pediatric Surgery and Pediatrics, Children's Healthcare of Atlanta, Atlanta, Georgia, USA Correspondence to Krista J. Childress, MD, Division of Gynecologic Specialties, Pediatric and Adolescent Gynecology, Department of Gynecology and Obstetrics, Emory University School of Medicine, 1400 Tullie Rd. NE, Floor 7, Atlanta, GA 30309, USA; Division of Pediatric Surgery and Pediatrics, Children's Healthcare of Atlanta, 1975 Century Blvd NE Suite 6, Atlanta, GA 30345, USA. Tel: +1 630 464 2689; e-mail: firstname.lastname@example.org Current Opinion in Obstetrics and Gynecology: October 2018 - Volume 30 - Issue 5 - p 316-325 doi: 10.1097/GCO.0000000000000484 Buy Metrics Abstract Purpose of review The purpose of this review is to outline ovarian conservation and fertility sparing surgery (FSS) in the management of the most common pediatric gynecology malignancies. Recent findings Management of gynecologic malignancies has evolved to have a greater appreciation for adverse late effects from radical surgery, chemotherapy, and radiation. A growing body of literature has led to a paradigm shift toward ovarian conservation and FSS in the management of pediatric ovarian malignancies and genitourinary rhabdomyosarcoma (RMS). The role of minimally invasive surgery is still being explored but guidelines support this approach as a viable option for early stage ovarian cancers when performed by skilled surgeons. Research continues to address settings in which adjuvant chemotherapy for ovarian cancer can be avoided. Treatment for genitourinary RMS has transitioned from radical surgery to a conservative multimodal approach with FSS, systemic chemotherapy, and targeted radiation. Summary FSS and ovarian conservation are emerging concepts in the management of gynecologic malignancies in young women. Conservative surgical approaches and avoidance of gonadotoxic chemotherapy and radiation to minimize acute and long-term complications while maintaining efficacy are important considerations. Fertility preservation techniques continue to evolve and offer young women the opportunity for future fertility and preservation of ovarian function. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.