Fertility-sparing surgery for malignancies in women.
Never before have women with newly diagnosed gynecologic malignancies had more options for preservation of fertility. Girls or women of childbearing age with several ovarian cancer subtypes have a high probability of unilateral ovarian involvement, and, thus, may be candidates for fertility-sparing surgery with preservation of a contralateral normal ovary and uterus. These subtypes include ovarian tumors of low malignant potential, malignant ovarian germ cell tumors, and ovarian sex cord-stromal tumors. For women with invasive epithelial ovarian cancer who have early-stage disease, fertility-sparing surgery may be an option. In some cases, fertility-sparing surgery may be followed by postoperative chemotherapy. For women with invasive cervical cancer, fertility-sparing surgery may be possible. Options include conization alone for stage IA1 or IA2 disease, radical trachelectomy with stage IA2 or IB disease, or ovarian transposition for women undergoing chemoradiation. Non-operative options, such as hormonal therapy, may be considered for women with early-stage, low-grade endometrial cancer. For all women of childbearing age with gynecologic malignancies, in vitro fertilization techniques or cryopreservation of ovarian tissue may be an option prior to definitive treatment.
Gershenson
David M
DM
Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center-Unit 1362, P.O. Box 301439, Houston, TX 77230-1439, USA. dgershen@mdanderson.org
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004714:Endometrial Hyperplasia / Q000188:drug therapy / Q000601:surgery; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery*; D010053:Ovary / Q000502:physiology; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000601:surgery*; D014599:Uterus / Q000502:physiology
D000970:Antineoplastic Agents