Page 57 - Test PDF v5

« Back to Contents MISCELLANEOUS

LiFE re

Literature for ENYGO

Fertility-sparing treatment in gynaecological malignancies

Editor Dimitris Papatheodorou Ovarian cancer

Descriptive summary Several systematic reviews were retrieved in this search, including
“Fertility-sparing surgery in epithelial ovarian cancer” by Bentivegna
In this literature search we retrieved articles on fertility-sparing et al. A meta-analysis by Shim et al. reported on a subgroup analysis
treatment in gynaecological malignancies. They are classified on studies with recurrence data after staging and fertility-sparing
according to the cancer site: surgery in patients with borderline ovarian tumours.

Endometrial cancer A comprehensive review by Zapardiel et al. regarding “Assisted
reproductive techniques (AST) after fertility-sparing treatments
A phase II study regarding the use of medroxyprogesterone acetate in gynaecological cancers” was published. There is an apparent
(MPA) plus metformin as a fertility -sparing treatment by Mitsuhashi oncological safety of ART and pregnancy can be achieved, however,
et al. enroled 17 patients with atypical endometrial hyperplasia and obstetrical outcomes may vary.
19 patients with endometrial cancer limited to the endometrium.
The authors found that metformin inhibited disease relapse after
MPA therapy and this particular drug combination should be studied
further. The study is also cited in “Treatment of endometrial hyper-
plasia (biology, conservative and definitive treatment, follow-up)” by
K. Dallaku.

A retrospective study by Gonthier et al. addressed the cancer
incidence in patients with atypical endometrial hyperplasia (AEH)
managed by primary hysterectomy or fertility-sparing treatment. In
this multicentric study 111 patients with AEH were included and
the authors conclude that the fertility -sparing management of AEH
does not increase the risk of diagnosing EC from the hysterectomy
specimen.

Cervical cancer

Johansen et al. conducted a retrospective study on reproductive and
oncologic outcomes following robot-assisted laparoscopic radical
trachelectomy of early-stage cervical cancer. 56 women were includ-
ed in this study; 81 % in the reproductive follow-up group managed
to conceive. A point of interest is the fact that the authors calcu-
lated only 21 patients of reproductive age although they performed
radical trachelectomy in 49 patients in total. So overall the number
of patients who managed to conceive is 34.6 % (17/49). The overall
number of premature deliveries was low (6 %).

Continued on the next page  Page 57

International Journal of Gynecological Cancer, Volume 26, Supplement #1