Fertility sparing techniques in patients with gynecologic cancer

Postgraduate Thesis uoadl:2839635 224 Read counter

Unit:
ΠΜΣ Παθολογία της Κύησης
Library of the School of Health Sciences
Deposit date:
2019-01-17
Year:
2018
Author:
Rigos Ioannis
Supervisors info:
Νικόλαος Παπαντωνίου, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Κασσάνος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χαράλαμπος Χρέλιας, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Θεραπείες διατήρησης γονιμότητας σε ασθενείς με γυναικολογικό καρκίνο
Languages:
Greek
Translated title:
Fertility sparing techniques in patients with gynecologic cancer
Summary:
Background: Gynaecologic malignancies are relatively frequent in the female population, with a global estimated incidence of 222,700 new cases in Europe. Although cancer in general affects aged population, a significant number of women develop cancer at younger age. In the last decade, 20% of patients had a first pregnancy after 40 years, resulting in a higher risk of cancer incidence before childbearing. Long-term survival rates after gynecological cancer, especially in young patients are increasing and all quality-of-life aspects, including preservation of fertility have become of major importance.
Methods: A research was performed in Medline, Pubmed, Medscape and Elsevier in order to find case reports, cohort studies, prospective or retrospective studies, systematic reviews of the literature and metaanalysis, using the keywords “endometrial cancer”, “ovarian cancer”, “cervical cancer”, “gynecologic cancer” , “malignancy”, “fertility sparing”, “conservative treatment”, “IVF”, “assisted reproduction”.
Results: Surgical techniques aimed at preserving fertility have been developed for women presenting with gynecological cancer found at early stages. Indications for fertility-sparing surgery are in general restricted to women presenting with a low-grade tumor in early stages or with low malignant potential. Until now, the use of fertility-sparing techniques in selected patients does not seem to affect overall survival negatively and fertility outcomes reported are favorable. Still larger amounts of data concerning advanced stages or higher grades of malignancy and longer follow-up periods are needed. Several current oncofertility treatments may result in subfertility and assisted reproduction techniques are indicated in these cases. Overall quality of life has been satisfactory in cancer patients after fertility-sparing surgery.
Conclusions: Fertility-sparing surgery is a viable tool to enable young patients with cancer to fulfill their family planning without impairment of oncological outcome. Cancer patients of reproductive age should undergo fertility counseling to analyze this sensitive subject.
Main subject category:
Health Sciences
Keywords:
Endometrial cancer, Ovarian cancer, Cervical cancer, Gynecologic cancer, Malignancy, Fertility sparing, Conservative treatment, IVF, Assisted reproduction
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
276
Number of pages:
119
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