Safety of assisted reproductive techniques in gynecological cancer patients.
Journal
Current opinion in oncology
ISSN: 1531-703X
Titre abrégé: Curr Opin Oncol
Pays: United States
ID NLM: 9007265
Informations de publication
Date de publication:
01 09 2023
01 09 2023
Historique:
medline:
9
8
2023
pubmed:
8
8
2023
entrez:
8
8
2023
Statut:
ppublish
Résumé
Gynecological cancer is a very important cause of comorbidity and mortality in women. The current delay in motherhood is increasing the incidence of women under 40 years of age that have not yet achieved their maternity goals when they are diagnosed and standard treatment negatively impacts the reproductive potential of cancer survivors. In this review, we update the information available about the safety of fertility-sparing treatments in young gynecological cancer patients, as well as the safety and efficacy of assisted reproductive techniques (ART) in such group. We also evaluate the long-term gynecological cancer risk in women requiring ART. Although eligibility criteria continue to be very strict, there are more and more reports of fertility-sparing approaches outside of what traditionally has been considered safe. Molecular assessment is starting to be used in the selection of appropriate candidates. Data increasingly shows the long term safety and the efficacy of ART and pregnancy in these patients. Appropriate selection is key to safely preconize fertility-sparing alternatives. Because subfertility may be a result of these procedures, ART could be indicated in this setting. Neither ART nor pregnancy appear to increase recurrences or affect survival rates.
Identifiants
pubmed: 37551948
doi: 10.1097/CCO.0000000000000976
pii: 00001622-202309000-00011
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
420-425Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Feichtinger M, Rodriguez-Wallberg KA. Fertility preservation in women with cervical, endometrial or ovarian cancers. Gynecol Oncol Res Pract 2016; 3:8.
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin 2022; 72:7–33.
Lago V, Marina T, Laseca Modrego M, et al. Fertility sparing treatment in patients with endometrial cancer (FERT-ENC): a multicentric retrospective study from the Spanish Investigational Network Gynecologic Oncology Group (SPAIN-GOG). Arch Gynecol Obstet 2022; 306:821–828.
Koh W-J, Abu-Rustum NR, Bean S, et al. Uterine neoplasms, version 1.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2018; 16:170–199.
Zhang X, Chen D, Zhao X, et al. Application of molecular classification to guiding fertility-sparing therapy for patients with endometrial cancer or endometrial intraepithelial neoplasia. Pathol Res Pract 2023; 241:154278.
Ronsini C, Mosca L, Iavarone I, et al. Oncological outcomes in fertility-sparing treatment in stage IA-G2 endometrial cancer. Vol. 12, Frontiers in oncology. Switzerland; 2022. p. 965029.
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 2023; 15:hoac057.
Zapardiel I, Cruz M, Diestro MD, et al. Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers. Hum Reprod Update 2016; 22:281–305.
Quintana-Bertó R, Padilla-Iserte P, Gil-Moreno A, et al. Oncological safety of hysteroscopy in endometrial cancer. Int J Gynecol Cancer 2022; 32:1395–1401.
Contreras N-A, Sabadell J, Verdaguer P, et al. Fertility-sparing approaches in atypical endometrial hyperplasia and endometrial cancer patients: current evidence and future directions. Int J Mol Sci 2022; 23:2531.
Azim A, Oktay K. Letrozole for ovulation induction and fertility preservation by embryo cryopreservation in young women with endometrial carcinoma. Fertil Steril 2007; 88:657–664.
Santaballa A, Márquez-Vega C, Rodríguez-Lescure Á, et al. Multidisciplinary consensus on the criteria for fertility preservation in cancer patients. Clin Transl Oncol 2022; 24:227–243.
Peremiquel-Trillas P, Frias-Gomez J, Alemany L, et al. Predicting ovarian-cancer burden in Catalonia by 2030: an age-period-cohort modelling. Int J Environ Res Public Health 2022; 19:1404.
Armstrong DK, Alvarez RD, Bakkum-Gamez JN, et al. Ovarian cancer, version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021; 19:191–226.
Prodromidou A, Theofanakis C, Thomakos N, et al. Fertility sparing surgery for early-stage clear cell carcinoma of the ovary; a systematic review and analysis of obstetric outcomes. Eur J Surg Oncol 2021; 47:1286–1291.
Nasioudis D, Heyward QD, Ko EM, et al. Fertility-sparing surgery for patients with stage IC2 or IC3 epithelial ovarian carcinoma: any evidence of safety? Int J Gynecol Cancer 2022; 32:165–171.
Li J, Chu R, Wang Z, et al. Analysis of the safety and pregnancy outcomes of fertility-sparing surgery in ovarian malignant sex cord-stromal tumours: a multicentre retrospective study. Clin Oncol (R Coll Radiol) 2023; 35:e206–e214.
Kuji S, Harada M, Yoshioka N, et al. Survival and reproductive outcomes after fertility-sparing surgery performed for borderline epithelial ovarian tumor in Japanese adolescents and young adults: results of a retrospective nationwide study. J Obstet Gynaecol Res 2022; 48:806–816.
Zhang Y, Wang QN, Huang Z, et al. Prognosis and fertility outcomes of patients with borderline ovarian tumors after fertility-sparing surgery. Zhonghua Yi Xue Za Zhi 2022; 102:1999–2004.
Rungoutok M, Suprasert P. Oncology and reproductive outcomes over 16 years of malignant ovarian germ cell tumors treated by fertility sparing surgery. World J Clin Oncol 2022; 13:802–812.
Wang L, Zhong Q, Tang Q, Wang H. Second fertility-sparing surgery and fertility-outcomes in patients with recurrent borderline ovarian tumors. Arch Gynecol Obstet 2022; 306:1177–1183.
Bartalot A, White M, Pejovict T, et al . Conservative management of stage IIB ovarian carcinoma with favorable oncology and fertility outcomes. Vol. 35, Gynecologic oncology reports. Netherlands; 2021. p. 100691.
Kasaven LS, Chawla M, Jones BP, et al. Fertility sparing surgery and borderline ovarian tumours. Cancers (Basel) 2022; 14:1485.
Liu D, Cai J, Gao A, et al. Fertility sparing surgery vs radical surgery for epithelial ovarian cancer: a meta-analysis of overall survival and disease-free survival. BMC Cancer 2020; 20:320.
Zhang Y-F, Fan Y, Mu Y, et al. 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:e29929.
Canlorbe G, Chabbert-Buffet N, Uzan C. Fertility-sparing surgery for ovarian cancer. J Clin Med 2021; 10:4235.
Park J-Y, Kim D-Y, Suh D-S, et al. Analysis of outcomes and prognostic factors after fertility-sparing surgery in malignant ovarian germ cell tumors. Gynecol Oncol 2017; 145:513–518.
Geoffron S, Lier A, de Kermadec E, et al. Fertility preservation in women with malignant and borderline ovarian tumors: Experience of the French ESGO-certified center and pregnancy-associated cancer network (CALG). Gynecol Oncol 2021; 161:817–824.
Cibula D, Pötter R, Planchamp F, 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. Radiother Oncol J Eur Soc Ther Radiol Oncol 2018; 127:404–416.
Wu C-J, Chang W-C, Chen C-H, et al. Radical trachelectomy for early stage cervical cancer: a case series and literature review. Taiwan J Obstet Gynecol 2017; 56:143–146.
Zusterzeel PLM, Aarts JWM, Pol FJM, et al. Neoadjuvant chemotherapy followed by vaginal radical trachelectomy as fertility-preserving treatment for patients with FIGO 2018 Stage 1B2 Cervical Cancer. Oncologist 2020; 25:e1051–e1059.
Willows K, Lennox G, Covens A. Fertility-sparing management in cervical cancer: balancing oncologic outcomes with reproductive success. Gynecol Oncol Res Pract 2016; 3:9.
Bentivegna E, Maulard A, Pautier P, et al. Fertility results and pregnancy outcomes after conservative treatment of cervical cancer: a systematic review of the literature. Fertil Steril 2016; 106:1195–1211. e5.
van der Plas RCJ, Bos AME, Jürgenliemk-Schulz IM, et al. Fertility-sparing surgery and fertility preservation in cervical cancer: The desire for parenthood, reproductive and obstetric outcomes. Gynecol Oncol 2021; 163:538–544.
Silvestris E, Paradiso AV, Minoia C, et al. Fertility preservation techniques in cervical carcinoma. Medicine (Baltimore) 2022; 101:e29163.
Salvo G, Ramirez PT, Leitao MM, et al. Open vs minimally invasive radical trachelectomy in early-stage cervical cancer: International Radical Trachelectomy Assessment Study. Am J Obstet Gynecol 2022; 226: 97.e1-97.e16.
Kasuga Y, Ikenoue S, Tanaka M, Ochiai D. Management of pregnancy after radical trachelectomy. Gynecol Oncol 2021; 162:220–225.
Lee S-A, Baik S, Chung S-H. Functional roles of female sex hormones and their nuclear receptors in cervical cancer. Essays Biochem 2021; 65:941–950.
Hanson B, Johnstone E, Dorais J, et al. Female infertility, infertility-associated diagnoses, and comorbidities: a review. J Assist Reprod Genet 2017; 34:167–177.
Barcroft JF, Galazis N, Jones BP, et al. Fertility treatment and cancers-the eternal conundrum: a systematic review and meta-analysis. Hum Reprod 2021; 36:1093–1107.
Rizzuto I, Behrens RF, Smith LA. Risk of ovarian cancer in women treated with ovarian stimulating drugs for infertility. Cochrane database Syst Rev 2019; 6:CD008215.
Spaan M, van den Belt-Dusebout AW, Lambalk CB, et al. Long-term risk of ovarian cancer and borderline tumors after assisted reproductive technology. J Natl Cancer Inst 2021; 113:699–709.
Skalkidou A, Sergentanis TN, Gialamas SP, et al. Risk of endometrial cancer in women treated with ovary-stimulating drugs for subfertility. Cochrane database Syst Rev 2017; 3:CD010931.
Diakosavvas M, Fasoulakis Z, Ntounis T, et al. A Potential pathogenic link between cancer of female reproductive system and infertile women treated with assisted reproduction techniques. In Vivo 2021; 35:1393–1399.
Guleria S, Jensen A, Albieri V, et al. Endometrial cancer risk after fertility treatment: a population-based cohort study. Cancer Causes Control 2021; 32:181–188.