title: [Fertility-sparing treatment for gynecologic cancer].
abstract: Japanese women bear children at a later age. Thus, fertility-sparing treatment for gynecologic cancer is very important. Per the Japanese treatment guidelines for cervical cancer, the uterus can be preserved by performing cervical conization alone in patients with stage I A1 disease. Radical trachelectomy (RT) is not yet recommended for patients with stage I A2 or I B 1 disease in Japan. Further, RT will not be popular in Japan because cervical cancer can be prevented with HPV vaccine. The efficacy of fertility-sparing treatment with a high-dose of medroxyprogesterone acetate for grade 1 endometrial cancer was proven in a Japan clinical oncology group (JCOG) phase II study. Japanese multi-institutional retrospective investigation data confirm that fertility-sparing surgery is safe for patients with stage I A disease with non-clear cell histology grade 1 or 2. These data suggest that patients with stage I A disease with clear cell histology and those with stage I C disease with non-clear cell histology grade 1 or 2 can be candidates for fertility sparing surgery followed by adjuvant chemotherapy.
authors: Dept. Obstetrics and Gynecology, NTT Medical Center Tokyo.
authors: Hajime
authors: H
authors: Tsunoda
mesh_terms: D017677:Age Distribution; D005260:Female; D005298:Fertility; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007247:Infertility, Female; D009367:Neoplasm Staging