Current state of fertility preservation for adolescent and young adult patients with gynecological cancer

Ohara, Tatsuru; Kuji, Shiho; Takenaga, Tomo; Imai, Hidenori; Endo, Hitomi; Kanamori, Ryo; Takeuchi, Jun; Nagasawa, Yuko; Yokomichi, Noriyuki; Kondo, Haruhiro; Deura, Imari; Tozawa, Akiko; Suzuki, Nao

doi:10.1007/s10147-021-02063-y

Cited by 7 publications

(4 citation statements)

References 64 publications

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“…When fertility-sparing surgery is an option in EOC, the surgery should include a unilateral salpingooophorectomy, avoiding the ovarian cystectomy if possible as it has shown a higher relapse rate [27], with contralateral ovary and uterus preservation and a complete surgical staging. However, the prevalence of lymphatic metastasis is very low in some histological subtypes, such as expansile mucinous carcinoma or low-grade serous carcinoma, so complete lymphadenectomy could be omitted [28][29][30][31]. Routine biopsy of a macroscopically normal contralateral ovary is not mandatory [32].…”

Section: Epithelial Ovarian Cancermentioning

confidence: 99%

Current limits of conservative treatment in ovarian cancer

Gracia¹,

Alonso-Espías²,

Zapardiel³

2023

Current Opinion in Oncology

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Purpose of review Fertility-sparing surgery in ovarian cancer is an increasing need in gynecology–oncology clinical practice because of the frequent childbearing delay in developed countries. As the evidence in literature is based on observational studies, this review focuses on summarizing the most recent and relevant evidence for the conservative management of young patients with ovarian cancer. Recent findings Staging surgery is mandatory in epithelial ovarian tumors. In sex cord-stromal tumors, fertility-sparing surgery is only recommended in FIGO stage IA. Due to its good prognosis, conservative treatment is possible in some cases of advanced disease of germ cell tumors and borderline tumors. Cystectomy is a reasonable option in serous borderline tumors but is not recommended in other tumor subtypes. Successful conception rates after fertility-sparing surgery ranges from 30 to 60%. Summary Fertility-sparing surgery is a well tolerated option in young women with early-stage ovarian cancer with acceptable reproductive outcomes.

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Section: Epithelial Ovarian Cancermentioning

confidence: 99%

Current limits of conservative treatment in ovarian cancer

Gracia¹,

Alonso-Espías²,

Zapardiel³

2023

Current Opinion in Oncology

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“…Moreover, the incidence of FeBGCs has escalated in China over the past three decades ( 4 , 5 ). What is even more concerning, FeBGCs are characterized by the correlation between the factors of reproduction, hormones, behavior ( 6 – 9 ), functional lesion infertility, and sexual and mental health of women ( 10 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiological trends of female breast and gynecologic cancers in adolescents and young adults in China from 1990 to 2019: Results from the Global Burden of Disease Study 2019

et al. 2022

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BackgroundResearch on the incidence, mortality, and disability-adjusted life years (DALYs) of female breast and gynecologic cancers (FeBGCs) and the relevant risk factors for adolescents and young adults (AYAs) are valuable for policy-making in China. We aimed to estimate the incidence, deaths, and DALYs and predict epidemiological trends of FeBGCs among AYAs in China between 1990 and 2019.MethodsData from the 2019 Global Burden of Disease (GBD) study between 1990 and 2019 in 195 countries and territories were retrieved. Data about the number of FeBGC incident cases, deaths, DALYs, age-standardized rates (ASRs), and estimated annual percentage changes (EAPCs) were extracted. A comparative risk assessment framework was performed to estimate the risk factors attributable to breast cancer deaths and DALYs, and autoregressive integrated moving average (ARIMA) models were fitted for time-series analysis to predict female cancer morbidity and mortality among Chinese AYAs until 2030.ResultsIn 2019, there are 61,038 incidence cases, 8,944 deaths, and 529,380 DALYs of FeBGCs among the AYAs in China, respectively. The estimated annual percentage change (EAPC) values were positive scores (>0) in ASIRs and negative scores (<0) in ASMR and ASDR. Furthermore, in 2030, the incidence rate of FeBGCs would grow to 30.49 per 100,000 in China, while the mortality rate would maintain a steady state. Of the deaths and DALYs, diet high in red meat was the greatest contributor to breast cancer, while a high body mass index (BMI) was the greatest contributor to cervical, ovarian, and uterine cancers.ConclusionThe increasing Chinese FeBGC burden is mainly observed in AYAs and non-red meat diet, and the control of body weight could reduce FeBGC burden in China.

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“…In particular, the frequency of invasive cervical cancer in pregnancy is reported to be 1-12 per 10,000 pregnancies [1][2][3]. Pregnancy-associated cervical cancer is a problem in Japan because of the increasing proportion of births among women aged ≥ 35 years [4,5] and the increasing incidence of cervical cancer among younger women [6]. In surveys of pregnant women with malignant disease conducted in 2008 and 2014, we identified cervical cancer as the most common type of cancer during pregnancy [7,8].…”

Section: Introductionmentioning

confidence: 99%

Trends in Pregnancy-Associated Cervical Cancer in Japan between 2012 and 2017: A Multicenter Survey

Enomoto

Yoshihara

Kondo

et al. 2022

Cancers

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Large-scale data on maternal and neonatal outcomes of pregnancy-associated cervical cancer in Japan are scarce, and treatment strategies have not been established. This multicenter retrospective observational study investigated clinical features and trends in pregnancy-associated cervical cancer treatments at 523 hospitals in Japan. We included cervical cancer cases that were histologically diagnosed (between 1 January 2012, and 31 December 2017), and their clinical information was retrospectively collected. Of 40 patients diagnosed with pregnancy-associated cervical cancer at ≥22 gestational weeks, 34 (85.0%) were carefully followed until delivery without intervention. Of 163 diagnosed at <22 gestational weeks, 111 continued and 52 terminated their pregnancy. Ninety patients with stage IB1 disease had various treatment options, including termination of pregnancy. The 59 stage IB1 patients who continued their pregnancy were categorized by the primary treatment into strict follow-up, conization, trachelectomy, and neoadjuvant chemotherapy groups, with no significant differences in progression-free or overall survival. The birth weight percentile at delivery was smaller in the neoadjuvant chemotherapy group than in the strict follow-up group (p = 0.029). Full-term delivery rate was relatively higher in the trachelectomy group (35%) than in the other groups. Treatment decisions for pregnancy-associated cervical cancer are needed after estimating the stage, considering both maternal and fetal benefits.

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Current state of fertility preservation for adolescent and young adult patients with gynecological cancer

Cited by 7 publications

References 64 publications

Current limits of conservative treatment in ovarian cancer

Current limits of conservative treatment in ovarian cancer

Epidemiological trends of female breast and gynecologic cancers in adolescents and young adults in China from 1990 to 2019: Results from the Global Burden of Disease Study 2019

Trends in Pregnancy-Associated Cervical Cancer in Japan between 2012 and 2017: A Multicenter Survey

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