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fertility and uterine cancer

B Borghese, P Santulli, L Marcellin, C Chapron
Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Endometriosis is a heterogeneous disease with three well-recognized subtypes that are often associated with each other: superficial endometriosis (SUP), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). DIE is frequently multifocal and mainly affects the following structures: the uterosacral ligaments, the posterior vaginal cul-de-sac, the bladder, the ureters, and the digestive tract (rectum, recto-sigmoid junction, appendix)...
March 11, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Natalia Pascuali, Leopoldina Scotti, Mariana Di Pietro, Gonzalo Oubiña, Diana Bas, María May, Antonio Gómez Muñoz, Patricia S Cuasnicú, Débora J Cohen, Marta Tesone, Dalhia Abramovich, Fernanda Parborell
STUDY QUESTION: Is ceramide-1-phosphate (C1P) an ovarian protective agent during alkylating chemotherapy? SUMMARY ANSWER: Local administration of C1P drastically reduces ovarian damage induced by cyclophosphamide (Cy) via protection of follicular reserve, restoration of hormone levels, inhibition of apoptosis and improvement of stromal vasculature, while protecting fertility, oocyte quality and uterine morphology. WHAT IS KNOWN ALREADY: Cancer-directed therapies cause accelerated loss of ovarian reserve and lead to premature ovarian failure (POF)...
March 9, 2018: Human Reproduction
Avi Ben-Haroush, Irit Ben-Aharon, Yechezkel Lande, Benjamin Fisch
BACKGROUND: Controlled ovarian hyperstimulation (COH) followed by oocyte retrieval is a leading option for fertility preservation before chemotherapy, yet this procedure causes excessive serum levels of estradiol (E2), which are often detrimental for cancer patients. Aromatase inhibitors are often used in breast cancer patients during COH to prevent elevated levels of E2. OBJECTIVES: To describe our experience with COH for oocyte cryopreservation in non-breast cancer patients using aromatase inhibitors...
March 2018: Israel Medical Association Journal: IMAJ
Hye Jin Chang, Hee Sung Shin, Tae Hoon Kim, Jung-Yoon Yoo, Hanna E Teasley, Jean J Zhao, Un-Hwan Ha, Jae-Wook Jeong
The PI3K/AKT signaling pathway plays a critical role in the maintenance of equilibrium between cell survival and apoptosis. The Pik3ca gene is mutated in a range of human cancers. It has been found to be oncogenic, and mutations lead to constitutive activation of the PI3K/AKT pathway. The expression patterns of PIK3CA proteins in the uterus of mice during early pregnancy indicate that it may play a role in the regulation of glandular epithelial cells, which is required to support uterine receptivity. To further investigate the role of Pik3ca in uterine function, Pik3ca was conditionally ablated only in the PGR-positive cells (Pgrcre/+Pik3caf/f; Pik3cad/d)...
2018: PloS One
Jung-Yun Lee, Yun Hwan Kim, Jong-Min Lee, Kidong Kim, Sokbom Kang, Myong Cheol Lim, Beob-Jong Kim, Bang Hyun Lee, Jae Weon Kim
Preoperative identification of individuals at low risk of lymph node metastasis is key to the proper management of endometrial cancer. This study evaluated the role of preoperative assessment based on magnetic resonance imaging (MRI) and histological analysis in identifying a group having a low risk of lymph node metastasis. Data of 529 patients with endometrial cancer were obtained from a prospective multicenter database, between January 2012 and December 2014. Clinical staging, based on MRI and histological analysis, was compared with final pathology results after the surgical staging procedure...
December 1, 2017: Oncotarget
Akimasa Takahashi, Hiroyuki Kanao, Nobuhiro Takeshima
STUDY OBJECTIVE: To describe a two-step fertility preservation technique for early-stage cervical cancer of a patient with a complete septate uterus. DESIGN: A step-by-step demonstration and explanation of the technique in a surgical video (Canadian Task Force Classification III). SETTING: Center for cancer, a tertiary referral center. The patient provided informed consent to use images and videos of the procedure. Institutional Review Board approval was not required for this kind of procedure...
November 13, 2017: Journal of Minimally Invasive Gynecology
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
Izumi Inoue, Fumiaki Nakamura, Kimikazu Matsumoto, Tetsuya Takimoto, Takahiro Higashi
OBJECTIVE: Adolescents and young adults (AYA) with cancer are confronted with unique challenges in areas of paramount concern within their age group, such as fertility, education, career, and delayed and long-term effects of treatment. However, the extent and depth of the problem has never been examined in the Japanese population. The aim of this study was to describe the status of cancer patients in the AYA population, using data from the hospital-based cancer registry (HBCR). STUDY DESIGN: Patients included in the HBCR from January 2011 to December 2014 were included in this study to evaluate the incidence and cancer distribution trends among AYA...
October 24, 2017: Cancer Epidemiology
Naomi S Clement, Thomas Rw Oliver, Hunain Shiwani, Juliane Rf Sanner, Caroline A Mulvaney, William Atiomo
BACKGROUND: Endometrial cancer is one of the most common gynaecological cancers in the world. Rates of endometrial cancer are rising, in part because of rising obesity rates. Endometrial hyperplasia is a precancerous condition in women that can lead to endometrial cancer if left untreated. Endometrial hyperplasia occurs more commonly than endometrial cancer. Progesterone tablets currently used to treat women with endometrial hyperplasia are associated with adverse effects in up to 84% of women...
October 27, 2017: Cochrane Database of Systematic Reviews
Sebastien Gouy, Marine Saidani, Amandine Maulard, Matthieu Faron, Slim Bach-Hamba, Enrica Bentivegna, Alexandra Leary, Patricia Pautier, Mojgan Devouassoux-Shisheboran, Catherine Genestie, Philippe Morice
According to the latest World Health Organization classification (2014), mucinous ovarian cancers should be classified histologically as being either expansile or infiltrative. Compared to other epithelial cancers, both of these mucinous patterns are diagnosed, in the main, at an early stage, although they can affect relatively young patients. The infiltrative subtype is characterized by a morphologically and clinically more aggressive disease versus the expansile form. Consequently, even in young patients who would prefer fertility sparing management, the removal of both ovaries (even for a unilateral tumor) remains a common recommendation...
November 2017: Gynecologic Oncology Reports
Dimitrios Nasioudis, Melissa K Frey, Eloise Chapman-Davis, Thomas A Caputo, Kevin Holcomb
OBJECTIVE: To evaluate the prevalence and safety of uterine preservation among premenopausal women diagnosed with a malignant ovarian germ-cell tumor (MOGCT) of advanced stage (stage II-IV). MATERIALS AND METHODS: The National Cancer Database was accessed and a cohort of women aged <40years, diagnosed with a MOGCT were identified. Those with stage II-IV disease who underwent cancer-directed surgery and received chemotherapy were selected for further analysis...
December 2017: Gynecologic Oncology
Jolene Wong, Grace Hwei Ching Tan, Ravichandran Nadarajah, Melissa Teo
Cervical myomas are rare and account for <1% of uterine leiomyomas. Clinical complications include bulk-related symptoms of pelvic pain, abnormal bleeding and infertility. While hysterectomies may be readily performed for postmenopausal women; the management of women with cervical myomas of childbearing age remains a challenge.Traditionally described fertility-preserving procedures such as myomectomy, endometrial ablation or myolysis may only be applied to leiomyomas within the uterine corpus. Little is known about the surgical management of its cervical counterpart...
October 9, 2017: BMJ Case Reports
J-Y Yoo, W S Yang, J H Lee, B G Kim, R R Broaddus, J M Lim, T H Kim, J-W Jeong
Endometrial cancer is the most common malignancy of the female genital tract. Progesterone (P4) has been used for several decades in endometrial cancer treatment, especially in women who wish to retain fertility. However, it is unpredictable which patients will respond to P4 treatment and which may have a P4-resistant cancer. Therefore, identifying the mechanism of P4 resistance is essential to improve the therapies for endometrial cancer. Mitogen-inducible gene 6 (Mig-6) is a critical mediator of progesterone receptor (PGR) action in the uterus...
September 18, 2017: Oncogene
Maria P Ruiz, Yongmei Huang, June Y Hou, Ana I Tergas, William M Burke, Cande V Ananth, Alfred I Neugut, Dawn L Hershman, Jason D Wright
BACKGROUND: Uterine-preserving therapy with progesterone may be used in young women with endometrial cancer who desire fertility preservation. Such therapy delays definitive treatment with hysterectomy. OBJECTIVE: We examined the use and safety of progestational therapy in young women with endometrial cancer. The primary outcome of the analysis was overall survival. STUDY DESIGN: We identified women ≤49 years of age with stage I endometrial cancer in the National Cancer Database from 2004 through 2014...
December 2017: American Journal of Obstetrics and Gynecology
Jerry Cheng-Yen Lai, Hung-Hui Chen, Kuei-Hui Chu, Chia-Sui Weng, Yiing-Jenq Chou, Nicole Huang, Yu-Ju Chien, Kung-Liahng Wang
OBJECTIVE: To describe the nationwide trends in the utilization of trachelectomy among Taiwanese women with surgically resectable cervical cancer over the past decade, and to compare associated demographic characteristics, in-hospital complications and related outcomes using a population-based dataset from 1998 to 2013. MATERIALS AND METHODS: We conducted a population-based, cohort study using inpatient admission claims data of Taiwan's National Health Insurance program...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
Osnat Elyashiv, Ron Sagiv, Ram Kerner, Ran Keidar, Joseph Menczer, Tally Levy
STUDY OBJECTIVE: The standard treatment of endometrial cancer (EC) and complex atypical hyperplasia (CAH) is hysterectomy with or without adnexectomy. In the last decade several centers have attempted to perform hysteroscopic resection of malignant and premalignant polyps as an alternative to hysterectomy. In the present study we evaluated the safety of this procedure in regard to residual uterine pathology. DESIGN: Retrospective chart review (Canadian Task Force classification II-2)...
November 2017: Journal of Minimally Invasive Gynecology
Camila Corzo, Natalia Barrientos Santillan, Shannon N Westin, Pedro T Ramirez
Endometrial cancer is the most common gynecologic cancer in the United States. It is typically diagnosed in postmenopausal women. However, given the increasing incidence of risk factors such as obesity and diabetes in younger women, it is becoming a more prevalent problem in this age group. When endometrial cancer is diagnosed in patients of reproductive age, the standard surgical option of hysterectomy and bilateral salpingo-oophorectomy may not be ideal for women interested in future fertility. Hence, conservative options for select patients should be discussed along with the associated outcomes of each approach...
August 3, 2017: Journal of Minimally Invasive Gynecology
Dimitrios Nasioudis, Eloise Chapman-Davis, Melissa K Frey, Steven S Witkin, Kevin Holcomb
OBJECTIVE: The aim of the present retrospective population-based study was to investigate the oncologic impact of uterine and ovarian preservation (OP) in premenopausal women with stage IA or IC ovarian clear cell carcinoma (OCCC). METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was accessed and a cohort of surgically-staged premenopausal women (age <50 years) diagnosed with unilateral stage IA or IC OCCC was drawn...
November 2017: Journal of Gynecologic Oncology
Z Ferraz, N Nogueira-Martins, F Nogueira-Martins
Adenomyosis is a benign invasion of endometrium into the myometrium. It produces a diffusely enlarged uterus and predominantly affects women in the late reproductive age. It has recently been associated with a negative impact on female fertility. Diagnosis is challenging because nonspecific symptoms can be present. However, it is asymptomatic in the majority of women. Medical treatment with GnRH agonist seems to be promising, particularly in subfertile women. A retrospective study was performed (182 patients) by examination of histopathological results with "adenomyosis" between January/2013 and September/2016...
March 2017: Facts, Views & Vision in ObGyn
Vinay Gunnala, Nigel Pereira, Mohamad Irani, Debra Lilienthal, Edyta C Pirog, Robert Soslow, Thomas A Caputo, Rony Elias, Isaac Kligman, Zev Rosenwaks
Hereditary leiomyomatosis renal cell cancer syndrome is an autosomal dominant disorder characterized by uterine and cutaneous leiomyomas and increased predisposition to renal cell carcinoma, papillary type II. The syndrome is caused by heterozygous mutations to the fumarate hydratase (FH) gene located on chromosome 1. Affected females generally present with early onset, atypical uterine leiomyomas and cutaneous findings, however, delays in diagnosis are very common in patients with isolated uterine findings...
July 11, 2017: International Journal of Gynecological Pathology
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