Next Article in Journal
Risk Factors of Esophageal Squamous Cell Carcinoma beyond Alcohol and Smoking
Next Article in Special Issue
Time to Pregnancy, Obstetrical and Neonatal Outcomes after Breast Cancer: A Study from the Maternity Network for Young Breast Cancer Patients
Previous Article in Journal
A Lung Organotypic Coculture Reveals a Role for TFEB-Lysosomal Axis in the Survival of Disseminated Dormant Cancer Cells
Previous Article in Special Issue
Evolution of Angiogenic Factors in Pregnant Patients with Breast Cancer Treated with Chemotherapy
Open AccessSystematic Review

Fertility-Sparing Surgery in Gynecologic Cancer: A Systematic Review

1
Department of Gynecologic Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
2
Department of Gynecology, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
3
Department of Scientific Information Service, Netherlands Cancer Institute, Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
4
Department of Oncology, Catholic University of Leuven, 3000 Leuven, Belgium
*
Author to whom correspondence should be addressed.
Both authors contributed equally.
Academic Editor: Francesco Boccardo
Cancers 2021, 13(5), 1008; https://doi.org/10.3390/cancers13051008
Received: 31 January 2021 / Revised: 22 February 2021 / Accepted: 23 February 2021 / Published: 28 February 2021
(This article belongs to the Special Issue Cancer and Pregnancy)
In Adolescents and Young Adults (AYAs), fertility is an important factor for good quality of life. In the case of cancer of the female reproductive tract, treatment can impair fertility and therefore, AYAs may face the life-changing decision whether or not to undergo conservative, fertility-sparing cancer treatment. Solid evidence on the safety as well as reproductive outcomes of these treatments is necessary to provide patients the information they need to make a well-informed choice. This systematic review aims to provide an overview of the best evidence available on both oncological and reproductive outcome after various fertility-sparing surgical options in cervical, ovarian, and endometrial cancer.
Fertility-sparing surgery (FSS) is increasingly being offered to women with a gynecological malignancy who wish to preserve fertility. In this systematic review, we evaluate the best evidence currently available on oncological and reproductive outcome after FSS for early stage cervical cancer, epithelial ovarian cancer, and endometrial cancer. An extensive literature search was conducted using the electronic databases Medline (OVID), Embase, and Cochrane Library to identify eligible studies published up to December 2020. In total, 153 studies were included with 7544, 3944, and 1229 patients who underwent FSS for cervical, ovarian, and endometrial cancer, respectively. We assessed the different FSS techniques that are available to preserve fertility, i.e., omitting removal of the uterine body and preserving at least one ovary. Overall, recurrence rates after FSS are reassuring and therefore, these conservative procedures seem oncologically safe in the current selection of patients with low-stage and low-grade disease. However, generalized conclusions should be made with caution due to the methodology of available studies, i.e., mostly retrospective cohort studies with a heterogeneous patient population, inducing selection bias. Moreover, about half of patients do not pursue pregnancy despite FSS and the reasons for these decisions have not yet been well studied. International collaboration will facilitate the collection of solid evidence on FSS and the related decision-making process to optimize patient selection and counseling. View Full-Text
Keywords: fertility-sparing surgery; conization; trachelectomy; hormonal therapy; cervical cancer; ovarian cancer; endometrial cancer; adolescents and young adults fertility-sparing surgery; conization; trachelectomy; hormonal therapy; cervical cancer; ovarian cancer; endometrial cancer; adolescents and young adults
Show Figures

Figure 1

MDPI and ACS Style

Schuurman, T.; Zilver, S.; Samuels, S.; Schats, W.; Amant, F.; van Trommel, N.; Lok, C. Fertility-Sparing Surgery in Gynecologic Cancer: A Systematic Review. Cancers 2021, 13, 1008. https://doi.org/10.3390/cancers13051008

AMA Style

Schuurman T, Zilver S, Samuels S, Schats W, Amant F, van Trommel N, Lok C. Fertility-Sparing Surgery in Gynecologic Cancer: A Systematic Review. Cancers. 2021; 13(5):1008. https://doi.org/10.3390/cancers13051008

Chicago/Turabian Style

Schuurman, Teska; Zilver, Sanne; Samuels, Sanne; Schats, Winnie; Amant, Frédéric; van Trommel, Nienke; Lok, Christianne. 2021. "Fertility-Sparing Surgery in Gynecologic Cancer: A Systematic Review" Cancers 13, no. 5: 1008. https://doi.org/10.3390/cancers13051008

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop