Sparing fertility in young patients with endometrial cancer

Chiva, Luis; Lapuente, Fernando; González-Cortijo, Lucía; Carballo, N.; Garcı́a, Juan F.; Rojo, Alejandro; González-Martín, Antonio

doi:10.1016/j.ygyno.2008.07.056

Cited by 110 publications

(94 citation statements)

References 20 publications

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“…Furthermore, certain gynecologic malignancies (e.g. early stage germ cell, cervical and endometrial tumors) are amenable to fertility-sparing procedures which have the potential to alter options available for appropriately-selected candidates [4,7,19,22,38]. Together, a strong and up-to-date knowledge base is essential to proper patient counseling.…”

Section: Discussionmentioning

confidence: 99%

Experiences in fertility preservation: lessons learned to ensure that fertility and reproductive autonomy remain options for cancer survivors

Noyes¹,

Melzer²,

Druckenmiller³

et al. 2013

J Assist Reprod Genet

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Purpose Assess fertility preservation (FP) measures chosen by patients newly diagnosed with malignancy and their outcomes. Methods Reproductive-age patients referred for FP underwent counseling and elected cryopreservation vs. no treatment. Outcome measures included ovarian stimulation, FP choice, oocytes/zygotes retrieved/cryopreserved and pregnancy outcome.Results From 2005 to 2012, 136 patients were counseled with 124 electing treatment: 83 oocyte-only, 21 oocyte+zygote and 20 zygote-only cryopreservation. Age, partnership and financial status factored into FP choice. Treatment was completed in 12±2 days with 14±11 metaphase-II oocytes harvested and cryopreserved/cycle. Eight patients returned to attempt pregnancy; three succeeded. Conclusions Our data demonstrate that oocyte and/or zygote banking are feasible FP options for women with malignancy; given the choice, the majority elected oocyte cryopreservation, highlighting desire for reproductive autonomy. Continued growth and research, combined with interdisciplinary communication, will ensure that appropriate candidates are offered FP and the potential for future parenthood, an important quality-oflife marker for survivors.

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Section: Discussionmentioning

confidence: 99%

Experiences in fertility preservation: lessons learned to ensure that fertility and reproductive autonomy remain options for cancer survivors

Noyes¹,

Melzer²,

Druckenmiller³

et al. 2013

J Assist Reprod Genet

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“…MPA 400 mg od 78% complete response in 6 months 22% partial response 22% recurrent disease between 10 and 22 months Chiva et al 20 …”

mentioning

confidence: 99%

Progestogen treatment options for early endometrial cancer

Cade¹,

Ma²,

Rm³

et al. 2010

BJOG

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Objective Premenopausal women with early endometrial cancer may wish to maintain their fertility, and for some patients nonsurgical treatment options may be attractive. We have examined our own experience with such patients, as there are limited published data so far to support clear guidelines in this area.Design Retrospective analysis of a case series.Setting Case series from a specialist gynaecological oncology unit in a major tertiary referral hospital.Sample Sixteen patients receiving progestogen therapy for stage-1 endometrial cancer.Methods We reviewed our experience of all patients receiving progestogen therapy for stage-1 endometrial cancer, and we particularly examined their cancer-free outcome and fertility potential.Main outcome measures Response to treatment, duration of response, and subsequent pregnancies.Results Of the 16 patients investigated, four received an oral progestogen, five received the levonorgestrel-releasing intrauterine system (Mirena), and seven received both forms of treatment. Ten patients (63%) responded to treatment, with a median time to response of 5.5 months. Six patients did not respond to treatment, but all were either early in treatment or opted for surgical management before the average time of response. No patient who responded had a later recurrence. The mean total follow-up time was 27 months (range 3-134 months), with no patient deaths. Three patients had successful pregnancies, with one patient having two children.Conclusions This form of treatment appears to be a realistic treatment option in selected patients in the closely supervised environment of a specialist gynaecological oncology unit.

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“…Thus conservative treatment of stage 1a and grade 1 endometrial adenocarcinoma is an available option in young women who wish to preserve their fertility. 16 According to the international literature, it appears that the most important factor for conservative treatment is selecting the "ideal patient" as given by Chiva L et al This is: 17 …”

Section: 13mentioning

confidence: 99%