Tóm tắt
Gynecological cancers comprise more than 30% of all cancer mortality in women worldwide and are responsible for an estimated 40% of all cancer incidence. Recently, there has been a significant surge in the prevalence of cancer diagnosis occurring at an earlier stage of life. As the number of cancer survivors increases, the preservation of fertility in women becomes critically important for patients and their families. In light of the fact that surgical excision of the reproductive organs is the primary cause of infertility, the optimal course of action is to modify the surgical approach. We conducted a literature review pertaining to provide a comprehensive summary of the presently accessible treatment approaches for preserving fertility in gynecologic malignancies, along with an analysis of their obstetrical and oncological outcomes.
Tài liệu tham khảo
1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA a Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660.
2. Zhao J, Xu L, Sun J, et al. Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncology 2023;2:e000049
3. “The world ovarian cancer coalition atlas 2023.” (2023).
4. Lambertini, M., Del Mastro, L., Pescio, M.C. et al. Cancer and fertility preservation: international recommendations from an expert meeting. BMC Med 14, 1 (2016). https://doi.org/10.1186/s12916-015-0545-7.
5. De Felice F, Marchetti C, Di Pinto A, Musella A, Palaia I, Porpora MG, Muzii L, Tombolini V, Panici PB, Tomao F. Fertility preservation in gynaecologic cancers. Ecancermedicalscience. 2018 Jan 16;12:798.
6. Silvestris E, Paradiso AV, Minoia C, Daniele A, Cormio G, Tinelli R, D'Oronzo S, Cafforio P, Loizzi V, Dellino M. Fertility preservation techniques in cervical carcinoma. Medicine (Baltimore). 2022 Apr 29;101(17):e29163.
7. Guimarães YM, Godoy LR, Longatto-Filho A, Reis RD. Management of early-stage cervical cancer: a literature review. Cancers (Basel). 2022;14(3):575. doi: 10.3390/cancers14030575.
8. Cibula D, Pötter R, Planchamp F, Avall-Lundqvist E, Fischerova D, Haie Meder C, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/ European Society of Pathology Guidelines for the Management of Patients with Cervical Cancer. Int J Gynecol Cancer. 2018;28(4):641-55. doi: 10.1097/IGC.0000000000001216.
9. Pessini SA, Carvalho JP, Reis RD, Filho ALDS, Primo WQSP. Fertility preservation in gynecologic cancer patients. Rev Bras Ginecol Obstet. 2023 Mar;45(3):161-168. doi: 10.1055/s-0043-1768564.
10. Zhang Q., Li W., Kanis M.J., Qi G., Li M., Yang X., Kong B. Oncologic and obstetrical outcomes with fertility-sparing treatment of cervical cancer: A systematic review and meta-analysis. Oncotarget. 2017;8:46580–46592. doi: 10.18632/oncotarget.16233.
11. Kuznicki M.L., Chambers L.M., Morton M., Son J., Horowitz M., Crean-Tate K.K., Hackett L., Rose P.G. Fertility-sparing surgery for early-stage cervical cancer: A systematic review of the literature. J. Minim. Invasive Gynecol. 2021;28:513–526.e1. doi: 10.1016/j.jmig.2020.10.013.
12. Shah JS, Jooya ND, Woodard TL, Ramirez PT, Fleming ND, Frumovitz M. Reproductive counseling and pregnancy outcomes after radical trachelectomy for early stage cervical cancer. J Gynecol Oncol. 2019;30(3):e45. doi: 10.3802/jgo.2019.30.e45.
13. Bentivegna E, Gouy S, Maulard A, Chargari C, Leary A, Morice P. Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review. Lancet Oncol. 2016;17(6):e240-53. doi: 10.1016/S1470-2045(16)30032-8.
14. Smith E.S., Moon A.S., O’Hanlon R., Leitao M.M., Sonoda Y., Abu-Rustum N.R., Mueller J.J. Radical trachelectomy for the treatment of early-stage cervical cancer: A systematic review. Obstet. Gynecol. 2020;136:533–542.
15. Rodolakis A, Scambia G, Planchamp F, et alESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinomaInternational Journal of Gynecologic Cancer 2023;33:208-223.
16. Mutlu L, Manavella DD, Gullo G, McNamara B, Santin AD, Patrizio P. Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Reproductive Outcomes. Cancers (Basel). 2022 Oct 22;14(21):5187
17. Chan J.K., Sherman A.E., Kapp D.S., Zhang R., Osann K.E., Maxwell L., Chen L.M., Deshmukh H. Influence of gynecologic oncologists on the survival of patients with endometrial cancer. J. Clin. Oncol. 2011;29:832–838.
18. Koh WJ, Abu-Rustum NR, Bean S, et al. Uterine neoplasms, version 1.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2018;16(2):170–199.
19. Rodolakis A., Biliatis I., Morice P., Reed N., Mangler M., Kesic V., Denschlag D. European Society of Gynecological Oncology Task Force for Fertility Preservation: Clinical Recommendations for Fertility-Sparing Management in Young Endometrial Cancer Patients. Int. J. Gynecol. Cancer. 2015;25:1258–1265.
20. Sundar S., Balega J., Crosbie E., Drake A., Edmondson R., Fotopoulou C., Gallos I., Ganesan R., Gupta J., Johnson N., et al. BGCS uterine cancer guidelines: Recommendations for practice. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017;213:71–97.
21. Terzic M, Norton M, Terzic S, Bapayeva G, Aimagambetova G. Fertility preservation in endometrial cancer patients: options, challenges and perspectives. Ecancermedicalscience. 2020 May 6;14:1030. doi: 10.3332/ecancer.2020.1030.
22. Fan Z, Li H, Hu R, et al. Fertility-preserving treatment in young women with grade 1 presumed stage IA endometrial adenocarcinoma: a meta-analysis. Int J Gynecol Cancer. 2018;28(2):385–393.
23. Herrera Cappelletti E, Humann J, Torrejón R, Gambadauro P. Chances of pregnancy and live birth among women undergoing conservative management of early-stage endometrial cancer: a systematic review and meta-analysis. Hum Reprod Update. 2022;28(02):282–95. doi: 10.1093/humupd/dmab041
24. Janda M, Robledo K P, Gebski V, Armes J E, Alizart M, Cummings M. Complete pathological response following levonorgestrel intrauterine device in clinically stage 1 endometrial adenocarcinoma: results of a randomized clinical trial. Gynecol Oncol. 2021;161(01):143–51. doi: 10.1016/j.ygyno.2021.01.029.
25. Trojano G, Olivieri C, Tinelli R, Damiani GR, Pellegrino A, Cicinelli E. Conservative treatment in early stage endometrial cancer: a review. Acta Biomed. 2019 Dec 23;90(4):405-410
26. Rodolakis A, Scambia G, Planchamp F, et al. ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma. Facts Views Vis Obgyn. Published online February 6, 2023. doi:10.52054/FVVO.14.4.054.
27. Ledermann JA, Matias-Guiu X, Amant F, et al. ESGO-ESMO-ESP consensus conference recommendations on ovarian cancer: pathology and molecular biology and early, advanced and recurrent disease. Ann Oncol. 2024;35(3):248-266.
28. Santos ML, Pais AS, Almeida Santos T. Fertility preservation in ovarian cancer patients. Gynecol Endocrinol. 2021;37(6):483-489.
29. Nitecki R, Clapp MA, Fu S, Lamiman K, Melamed A, Brady P, et al. Outcomes of the first pregnancy after fertility-sparing surgery for early-stage ovarian cancer. Obstet Gynecol. 2021;137(6):1109-18.
30. Daraï E, Fauvet R, Uzan C, Gouy S, Duvillard P, Morice P. Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options. Hum Reprod Update. 2013;19(2):151-66.
31. Zhang YF, Fan Y, Mu Y, Zhang P, Wang MY, Li JK. Reproductive and oncological outcomes of fertility-sparing surgery in patients with stage I epithelial ovarian cancer: A systematic review and meta-analysis. Medicine (Baltimore). 2022;101(31):e29929.
32. Taylan E, Oktay K. Fertility preservation in gynecologic cancers. Gynecol Oncol. 2019;155(3):522-529.
33. Carneiro MM, Lamaita RM, Ferreira MC, Silva-Filho AL. Fertility-preservation in endometrial cancer: is it safe? Review of the literature. JBRA Assist Reprod. 2016 Dec 1;20(4):232-239.
34. Bourou MZ, Matsas A, Vrekoussis T, Mastorakos G, Valsamakis G, Panoskaltsis T. Conservative treatment of endometrial cancer in women of reproductive age (Review). Mol Clin Oncol. 2023 May 25;19(1):55
2. Zhao J, Xu L, Sun J, et al. Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. BMJ Oncology 2023;2:e000049
3. “The world ovarian cancer coalition atlas 2023.” (2023).
4. Lambertini, M., Del Mastro, L., Pescio, M.C. et al. Cancer and fertility preservation: international recommendations from an expert meeting. BMC Med 14, 1 (2016). https://doi.org/10.1186/s12916-015-0545-7.
5. De Felice F, Marchetti C, Di Pinto A, Musella A, Palaia I, Porpora MG, Muzii L, Tombolini V, Panici PB, Tomao F. Fertility preservation in gynaecologic cancers. Ecancermedicalscience. 2018 Jan 16;12:798.
6. Silvestris E, Paradiso AV, Minoia C, Daniele A, Cormio G, Tinelli R, D'Oronzo S, Cafforio P, Loizzi V, Dellino M. Fertility preservation techniques in cervical carcinoma. Medicine (Baltimore). 2022 Apr 29;101(17):e29163.
7. Guimarães YM, Godoy LR, Longatto-Filho A, Reis RD. Management of early-stage cervical cancer: a literature review. Cancers (Basel). 2022;14(3):575. doi: 10.3390/cancers14030575.
8. Cibula D, Pötter R, Planchamp F, Avall-Lundqvist E, Fischerova D, Haie Meder C, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/ European Society of Pathology Guidelines for the Management of Patients with Cervical Cancer. Int J Gynecol Cancer. 2018;28(4):641-55. doi: 10.1097/IGC.0000000000001216.
9. Pessini SA, Carvalho JP, Reis RD, Filho ALDS, Primo WQSP. Fertility preservation in gynecologic cancer patients. Rev Bras Ginecol Obstet. 2023 Mar;45(3):161-168. doi: 10.1055/s-0043-1768564.
10. Zhang Q., Li W., Kanis M.J., Qi G., Li M., Yang X., Kong B. Oncologic and obstetrical outcomes with fertility-sparing treatment of cervical cancer: A systematic review and meta-analysis. Oncotarget. 2017;8:46580–46592. doi: 10.18632/oncotarget.16233.
11. Kuznicki M.L., Chambers L.M., Morton M., Son J., Horowitz M., Crean-Tate K.K., Hackett L., Rose P.G. Fertility-sparing surgery for early-stage cervical cancer: A systematic review of the literature. J. Minim. Invasive Gynecol. 2021;28:513–526.e1. doi: 10.1016/j.jmig.2020.10.013.
12. Shah JS, Jooya ND, Woodard TL, Ramirez PT, Fleming ND, Frumovitz M. Reproductive counseling and pregnancy outcomes after radical trachelectomy for early stage cervical cancer. J Gynecol Oncol. 2019;30(3):e45. doi: 10.3802/jgo.2019.30.e45.
13. Bentivegna E, Gouy S, Maulard A, Chargari C, Leary A, Morice P. Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review. Lancet Oncol. 2016;17(6):e240-53. doi: 10.1016/S1470-2045(16)30032-8.
14. Smith E.S., Moon A.S., O’Hanlon R., Leitao M.M., Sonoda Y., Abu-Rustum N.R., Mueller J.J. Radical trachelectomy for the treatment of early-stage cervical cancer: A systematic review. Obstet. Gynecol. 2020;136:533–542.
15. Rodolakis A, Scambia G, Planchamp F, et alESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinomaInternational Journal of Gynecologic Cancer 2023;33:208-223.
16. Mutlu L, Manavella DD, Gullo G, McNamara B, Santin AD, Patrizio P. Endometrial Cancer in Reproductive Age: Fertility-Sparing Approach and Reproductive Outcomes. Cancers (Basel). 2022 Oct 22;14(21):5187
17. Chan J.K., Sherman A.E., Kapp D.S., Zhang R., Osann K.E., Maxwell L., Chen L.M., Deshmukh H. Influence of gynecologic oncologists on the survival of patients with endometrial cancer. J. Clin. Oncol. 2011;29:832–838.
18. Koh WJ, Abu-Rustum NR, Bean S, et al. Uterine neoplasms, version 1.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2018;16(2):170–199.
19. Rodolakis A., Biliatis I., Morice P., Reed N., Mangler M., Kesic V., Denschlag D. European Society of Gynecological Oncology Task Force for Fertility Preservation: Clinical Recommendations for Fertility-Sparing Management in Young Endometrial Cancer Patients. Int. J. Gynecol. Cancer. 2015;25:1258–1265.
20. Sundar S., Balega J., Crosbie E., Drake A., Edmondson R., Fotopoulou C., Gallos I., Ganesan R., Gupta J., Johnson N., et al. BGCS uterine cancer guidelines: Recommendations for practice. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017;213:71–97.
21. Terzic M, Norton M, Terzic S, Bapayeva G, Aimagambetova G. Fertility preservation in endometrial cancer patients: options, challenges and perspectives. Ecancermedicalscience. 2020 May 6;14:1030. doi: 10.3332/ecancer.2020.1030.
22. Fan Z, Li H, Hu R, et al. Fertility-preserving treatment in young women with grade 1 presumed stage IA endometrial adenocarcinoma: a meta-analysis. Int J Gynecol Cancer. 2018;28(2):385–393.
23. Herrera Cappelletti E, Humann J, Torrejón R, Gambadauro P. Chances of pregnancy and live birth among women undergoing conservative management of early-stage endometrial cancer: a systematic review and meta-analysis. Hum Reprod Update. 2022;28(02):282–95. doi: 10.1093/humupd/dmab041
24. Janda M, Robledo K P, Gebski V, Armes J E, Alizart M, Cummings M. Complete pathological response following levonorgestrel intrauterine device in clinically stage 1 endometrial adenocarcinoma: results of a randomized clinical trial. Gynecol Oncol. 2021;161(01):143–51. doi: 10.1016/j.ygyno.2021.01.029.
25. Trojano G, Olivieri C, Tinelli R, Damiani GR, Pellegrino A, Cicinelli E. Conservative treatment in early stage endometrial cancer: a review. Acta Biomed. 2019 Dec 23;90(4):405-410
26. Rodolakis A, Scambia G, Planchamp F, et al. ESGO/ESHRE/ESGE Guidelines for the fertility-sparing treatment of patients with endometrial carcinoma. Facts Views Vis Obgyn. Published online February 6, 2023. doi:10.52054/FVVO.14.4.054.
27. Ledermann JA, Matias-Guiu X, Amant F, et al. ESGO-ESMO-ESP consensus conference recommendations on ovarian cancer: pathology and molecular biology and early, advanced and recurrent disease. Ann Oncol. 2024;35(3):248-266.
28. Santos ML, Pais AS, Almeida Santos T. Fertility preservation in ovarian cancer patients. Gynecol Endocrinol. 2021;37(6):483-489.
29. Nitecki R, Clapp MA, Fu S, Lamiman K, Melamed A, Brady P, et al. Outcomes of the first pregnancy after fertility-sparing surgery for early-stage ovarian cancer. Obstet Gynecol. 2021;137(6):1109-18.
30. Daraï E, Fauvet R, Uzan C, Gouy S, Duvillard P, Morice P. Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options. Hum Reprod Update. 2013;19(2):151-66.
31. Zhang YF, Fan Y, Mu Y, Zhang P, Wang MY, Li JK. Reproductive and oncological outcomes of fertility-sparing surgery in patients with stage I epithelial ovarian cancer: A systematic review and meta-analysis. Medicine (Baltimore). 2022;101(31):e29929.
32. Taylan E, Oktay K. Fertility preservation in gynecologic cancers. Gynecol Oncol. 2019;155(3):522-529.
33. Carneiro MM, Lamaita RM, Ferreira MC, Silva-Filho AL. Fertility-preservation in endometrial cancer: is it safe? Review of the literature. JBRA Assist Reprod. 2016 Dec 1;20(4):232-239.
34. Bourou MZ, Matsas A, Vrekoussis T, Mastorakos G, Valsamakis G, Panoskaltsis T. Conservative treatment of endometrial cancer in women of reproductive age (Review). Mol Clin Oncol. 2023 May 25;19(1):55
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