Fertility-sparing management of gynecological cancers

Fastrez, Maxime; Houba, Catherine; Vandromme, Jean; Rozenberg, Serge

doi:10.1016/j.maturitas.2015.06.031

Cited by 7 publications

(3 citation statements)

References 38 publications

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“…A 2011 review reported live delivery rates of 80% in patients with germ‐cell tumors compared with 58% in borderline tumors; the review reported that recurrences are observed in 10%–18% of patients and that, following progestin therapy for endometrial cancer, 26%–47% of the pregnancies included in the review resulted in live deliveries . A subsequent review reported cumulative pregnancy rates of 61% and 35% in patients with early‐stage borderline tumors and germ‐cell tumors, respectively, and a pooled live delivery rate of 28% following endometrial malignancies . The live delivery rate in the present study (12 [80%] live deliveries of 15 pregnancies) was comparable to these previous data; few recurrences were noted and this could be related to the small sample size (Table ).…”

Section: Patient Demographic Data and Obstetric Outcomes (N = 12)mentioning

confidence: 99%

Obstetric outcomes following fertility‐preserving management of gynecologic malignancies

Narigapalli

Gundabattula

Pochiraju

et al. 2017

Intl J Gynecology & Obste

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Section: Patient Demographic Data and Obstetric Outcomes (N = 12)mentioning

confidence: 99%

Obstetric outcomes following fertility‐preserving management of gynecologic malignancies

Narigapalli

Gundabattula

Pochiraju

et al. 2017

Intl J Gynecology & Obste

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“…Cisplatin-based regimens are now preferred because they seem to offer a better fertility outcome than non-cisplatin-based chemotherapies. Fertility-sparing surgery may be the standard treatment in young patients with early-stage BOTs [32]. …”

Section: Special Concerns In Breast and Ovarian Cancermentioning

confidence: 99%

SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016)

et al. 2016

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Chemotherapy and radiotherapy often result in reduced fertility in cancer patients. With increasing survival rates, fertility is an important quality-of-life concern for many young cancer patients. Around 70–75% of young cancer survivors are interested in parenthood but the numbers of patients who access fertility preservation techniques prior to treatment are significantly lower. Moreover, despite existing guidelines, healthcare professionals do not address fertility preservation issues adequately. There is a critical need for improvements in clinical care to ensure patients are well informed about infertility risks and fertility preservation options and to support them in their reproductive decision-making prior to cancer treatment.

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“…Fertility-sparing approaches in young patients with a diagnosis of cancer are recommended by international guidelines [17]. However, the conservative management of uterus and adnexa preservation in women affected by gynecological malignancies, such as EC and AEH, has the risk of cancer persistence and recurrence [18,19]. Therefore, developing standardized and evidence-based management is paramount, with a clear definition of eligible criteria, primary lesion treatment, and follow-up modality.…”

Section: Introductionmentioning

confidence: 99%

Conservative Management of Atypical Endometrial Hyperplasia and Early Endometrial Cancer in Childbearing Age Women

et al. 2022

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Total hysterectomy and bilateral adnexectomy is the standard treatment for atypical endometrial hyperplasia and early-stage endometrial cancer. However, the recommended surgical treatment precludes future pregnancy when these conditions are diagnosed in women in their fertile age. In these patients, fertility-sparing treatment may be feasible if the desire for childbearing is consistent and specific conditions are present. This review summarizes the available evidence on fertility-sparing management for atypical endometrial hyperplasia and early-stage endometrial cancer. Historically, oral progestins have been the mainstay of conservative management for atypical endometrial hyperplasia and stage IA endometrioid endometrial cancer with no myometrial invasion, although there is no consensus on dosage and treatment length. Intrauterine progestin therapy has proved a valid alternative option when oral progestins are not tolerated. GnRH analogs, metformin, and hysteroscopic resection in combination with progestins appear to increase the overall efficacy of the treatment. After a complete response, conception is recommended; alternatively, maintenance therapy with strict follow-up has been proposed to decrease recurrence. The risk of disease progression is not negligible, and clinicians should not overlook the risk of hereditary forms of the disease in young patients, in particular, Lynch syndrome. Hysterectomy is performed once the desire for childbearing desire has been established. The conservative management of atypical endometrial hyperplasia and early-stage endometrial cancer is feasible, provided a strong desire for childbearing and permitting clinical–pathological conditions. However, patients must be aware of the need for a strict follow-up and the risk of progression with a possible consequent worsening of the prognosis. More homogenous and well-designed studies are necessary to standardize and identify the best treatment and follow-up protocols.

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Fertility-sparing management of gynecological cancers

Cited by 7 publications

References 38 publications

Obstetric outcomes following fertility‐preserving management of gynecologic malignancies

Obstetric outcomes following fertility‐preserving management of gynecologic malignancies

SEOM Clinical Guideline of fertility preservation and reproduction in cancer patients (2016)

Conservative Management of Atypical Endometrial Hyperplasia and Early Endometrial Cancer in Childbearing Age Women

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