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fertility and uterine cancer

Giulio Formoso, Enrica Perrone, Susanna Maltoni, Sara Balduzzi, Jack Wilkinson, Vittorio Basevi, Anna Maria Marata, Nicola Magrini, Roberto D'Amico, Chiara Bassi, Emilio Maestri
BACKGROUND: Tibolone is a synthetic steroid used for the treatment of menopausal symptoms, on the basis of short-term data suggesting its efficacy. We considered the balance between the benefits and risks of tibolone. OBJECTIVES: To evaluate the effectiveness and safety of tibolone for treatment of postmenopausal and perimenopausal women. SEARCH METHODS: In October 2015, we searched the Gynaecology and Fertility Group (CGF) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO (from inception), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and clinicaltrials...
October 12, 2016: Cochrane Database of Systematic Reviews
Christhardt Köhler, Simone Marnitz, Peter Biel, Tim Cordes
Anal cancer was diagnosed in a 36-year-old nulliparous woman. Before chemoradiation was started, ovarian transposition and uterine fixation were performed in order to preserve capability for future parenthood. Despite of a low anti-Mullerian hormone level, IVF therapy was successful and resulted in a full-term delivery of a healthy baby by cesarean section. This is the first case report of successful pregnancy after full-dose pelvic radiation for anal cancer.
September 28, 2016: Oncology
Geneviève Bouchard-Fortier, Raymond H Kim, Lisa Allen, Abha Gupta, Taymaa May
OBJECTIVE: To report three cases of embryonal rhabdomyosarcoma (ERMS) of the cervix in young women successfully treated with fertility-sparing surgery and chemotherapy. METHODS: Between January 2014 and December 2015, three cases of ERMS of the cervix were confirmed in young women at a single tertiary cancer center. All cases were managed by a pediatric oncologist and a gynecologic oncologist with a combination of surgery and chemotherapy. Fertility-sparing surgeries (cervical conization or robotic-assisted radical trachelectomy) were offered to patients depending on the tumor size...
November 2016: Gynecologic Oncology Reports
Nikolaos Thomakos, Sofia-Paraskevi Trachana, Miona Davidovic-Grigoraki, Alexandros Rodolakis
Cancer of the uterine cervix, following breast cancer, is the second leading cause of death among gynecological cancers in the developed world. Traditionally, surgical management of early-stage cervical carcinoma is considered as a "sterilizing" procedure, since the uterus is removed. Nowadays, because of the postponement of childbearing to an older age, women younger than 45 years old who are diagnosed with early-stage cervical cancer have a strong desire to preserve fertility. Radical trachelectomy (vaginal or abdominal route) is used for fertility preservation in cases of early-stage (International Federation of Gynecology and Obstetrics Stages IA-IB1) cervical carcinomas with remarkable oncological and obstetrical outcomes...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
Seiya Sato, Hiroaki Itamochi, Toru Sugiyama
The standard treatment for early cervical cancer of the uterus (CC) is radical hysterectomy with resection of the parametrium and pelvic lymphadenectomy. At least 40% of patients develop early-stage CC during child-bearing age, therefore preserving the uterus to maintain fertility has been an important consideration. Several surgical procedures including conization and vaginal or abdominal radical trachelectomy have been reported. These procedures are safe for removing lymph node negative CC tumors with <2 cm diameter...
October 2016: Future Oncology
Y X Sun, Q Liu, K J Liu, P Q Li, Z J Hu
OBJECTIVE: To explore the outcomes of the oncology, the fertility and pregnancy on patients with early-stage cervical cancer after undergoing fertility-sparing treatments, and to investigate its value on clinical treatment. METHODS: A total of 29 patients with cervical cancer (stage Ⅰa2-Ⅰb1) who had undergone the fertility- sparing treatments in Renji Hospital, School of Medicine, Shanghai Jiaotong University from February 2010 to September 2015 were analyzed retrospectively...
June 25, 2016: Zhonghua Fu Chan Ke za Zhi
Arnulfo Martínez-Chapa, Nelly Alonso-Reyes, Miguel Luna-Macías
BACKGROUND: Historically, cervical cancer in early stages has been treated with radical hysterectomy and radiotherapy with no option in keeping the uterine-ovarian function. Since two decades ago, evidence shows these cases are candidates for radical trachelectomy, a procedure capable of preserving the fertility without affecting the oncological outcome. OBJECTIVE: To analyze reproductive results among patients treated with radical trachelectomy, in a reference center from the northeast of Mexico...
December 2015: Ginecología y Obstetricia de México
Charis Bourgioti, Konstantinos Chatoupis, Lia Angela Moulopoulos
Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status...
April 28, 2016: World Journal of Radiology
Rashmi Kudesia, Satu Kuokkanen
Receptive endometrium is essential for successful implantation and ongoing pregnancy. Significant health issues and associated therapies, especially oncologic therapies, have potential to negatively impact future fertility in young women. Irradiation and chemotherapeutic alkylating agents are known to cause ovarian failure in most females; however, less well is characterized the impact of irradiation on uterine development and integrity. With an increasing number of cancer survivors, women are seeking infertility treatment after such therapies...
April 29, 2016: Gynecological Endocrinology
Yasuhiko Ebina, Hidetaka Katabuchi, Mikio Mikami, Satoru Nagase, Nobuo Yaegashi, Yasuhiro Udagawa, Hidenori Kato, Kaneyuki Kubushiro, Kiyoshi Takamatsu, Kazuhiko Ino, Hiroyuki Yoshikawa
The third version of the Japan Society of Gynecologic Oncology guidelines for the treatment of uterine body neoplasms was published in 2013. The guidelines comprise nine chapters and nine algorithms. Each chapter includes a clinical question, recommendations, background, objectives, explanations, and references. This revision was intended to collect up-to-date international evidence. The highlights of this revision are to (1) newly specify costs and conflicts of interest; (2) describe the clinical significance of pelvic lymph node dissection and para-aortic lymphadenectomy, including variant histologic types; (3) describe more clearly the indications for laparoscopic surgery as the standard treatment; (4) provide guidelines for post-treatment hormone replacement therapy; (5) clearly differentiate treatment of advanced or recurrent cancer between the initial treatment and the treatment carried out after the primary operation; (6) collectively describe fertility-sparing therapy for both atypical endometrial hyperplasia and endometrioid adenocarcinoma (corresponding to G1) and newly describe relapse therapy after fertility-preserving treatment; and (7) newly describe the treatment of trophoblastic disease...
June 2016: International Journal of Clinical Oncology
Miseon Kim, Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Baba, Masahito Mizuuchi, Sakura Takada, Tsuyoshi Saito
AIM: Radical trachelectomy (RT) with lymphadenectomy has become a standard treatment modality for patients with early invasive uterine cervical cancer who hope to preserve fertility. However, pregnancy after RT has high risks of preterm birth. The possibility of more conservative RT and the application of RT for patients with higher clinical stages were studied. METHODS: The medical charts and specimens of 42 patients who underwent RT and 64 patients who underwent radical hysterectomy were retrospectively studied...
July 2016: Journal of Obstetrics and Gynaecology Research
Yuan Yang Yao, Yue Wang, Jian Liu Wang, Chao Zhao, Li Hui Wei
OBJECTIVE: To explore the outcomes of oncology, fertility, and pregnancy in patients after undergoing neoadjuvant chemotherapy (NACT) followed by fertility-sparing operations with cervical cancer, and its value in clinical treatment. MATERIALS AND METHODS: A total of 11 patients from seven hospitals in Beijing with cervical cancer since August 2009 to December 2011, who had undergone fertility- sparing treatments were recruited in this study. RESULTS: Among the 11 patients, there were nine cases of squamous cell carcinoma, two cases of adenocarcinoma, one case in Stage IA2, and ten cases in Stage IB1 (FIGO, 2009)...
2016: European Journal of Gynaecological Oncology
Sung Mee Kim, So Jin Shin, Jin Gon Bae, Kun Young Kwon, Jeong Ho Rhee
Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation...
March 2016: Obstetrics & Gynecology Science
Xiyin Wang, Shikha Khatri, Russell Broaddus, Zhong Wang, Shannon M Hawkins
Women with endometriosis can suffer from decreased fecundity or complete infertility via abnormal oocyte function or impaired placental-uterine interactions required for normal pregnancy establishment and maintenance. Although AT-rich interactive domain 1A (SWI-like) (ARID1A) is a putative tumor suppressor in human endometrial cancers and endometriosis-associated ovarian cancers, little is known about its role in normal uterine function. To study the potential function of ARID1A in the female reproductive tract, we generated mice with a conditional knockout of Arid1a using anti-Müllerian hormone receptor 2-Cre Female Arid1a conditional knockout mice exhibited a progressive decrease in number of pups per litter, with a precipitous decline after the second litter...
April 2016: Biology of Reproduction
Y Kornovski, E Ismail, S Ivanov
Cervical cancer is the most common gynecologic malignancy during pregnancy. Laparoscopic pelvic lymphadenectomy and the nodal status are the main factors to tailor therapeutic approaches and to terminate or preserve the pregnancy. In node-negative pregnants neoadjuvant chemotherapy can be administered safely after 13 week of gestation in order to achive fetal maturity. In these cases, mostly in early stages, fertility- preserving techniques, such as vaginal simple or radical trachelectomy can be performed.
2015: Akusherstvo i Ginekologii︠a︡
W A A Tjalma
Almost 1% of all cervical cancers occur in pregnant women. The recommended management during the first 20 weeks is to sacrifice the pregnancy and to perform standard therapy, which means the loss of future fertility. A trachelectomy during pregnancy could preserve the ongoing pregnancy and future fertility. The author reports a radical vaginal trachelectomy (RVT) during 18 weeks of pregnancy. Definitive pathology of the trachelectomy specimen showed a tumor of 48 millimeters. Subsequently a radical hysterectomy was performed...
2015: European Journal of Gynaecological Oncology
Viveca Söderström-Anttila, Anneli Miettinen, Anna Rotkirch, Sinikka Nuojua-Huttunen, Anna-Kaisa Poranen, Mari Sälevaara, Anne-Maria Suikkari
STUDY QUESTION: What are the short- and long-term health consequences and current satisfaction of altruistic oocyte donors? SUMMARY ANSWER: Donating oocytes in the majority (>90%) of donation cycles is not associated with harmful long-term general or reproductive health effects. WHAT IS KNOWN ALREADY: Knowledge of long-term health effects of oocyte donation on donors is sparse and follow-up studies have usually been carried out on commercial donors...
March 2016: Human Reproduction
Claire L Newton, Ross C Anderson, Robert P Millar
Reproductive hormones play a role at all stages of life and affect most tissues of the body. Gonadotropin-releasing hormone (GnRH) synthesized in the hypothalamus stimulates the secretion of gonadotropins which in turn stimulate gonadal sex hormone production and gamete formation. This hypothalamic-pituitary-gonadal (HPG) axis has, therefore, been the target for the development of numerous drugs which regulate it at various points. These include sex steroid agonists and antagonists, inhibitors of sex steroid biosynthesis, and GnRH agonists and antagonists, which have found extensive applications in treating numerous conditions such as precocious puberty, delayed puberty, prostate cancer, benign prostatic hyperplasia, endometriosis, uterine fibroids and also in in vitro fertilization protocols...
2016: Endocrine Development
Pawel Basta, Wojciech Kolawa, Klaudia Stangel-Wójcikiewicz, Janina Schwarz
OBJECTIVE: The aim of the study was to evaluate the possibility of conception and the course of pregnancy in women with cervical cancer (FIGO IA and IB1), who underwent fertility-sparing surgical management, i.e. surgical conization or radical vaginal trachelectomy with laparoscopic lymphadenectomy. MATERIAL AND METHODS: A total of 80 patients treated surgically due to cervical cancer constituted the study group. Out of them, 65 (85%) women underwent surgical conization (43--FIGO IA1 and 25--FIGO IA2), and 12 (15%) women underwent radical vaginal trachelectomy with laparoscopic lymphadenectomy (9--FIGO IA2 and 3--FIGO lB1)...
September 2015: Ginekologia Polska
Audrey Tieko Tsunoda, Carlos Eduardo Mattos da Cunha Andrade, Marcelo Andrade Vieira, Ricardo dos Reis
Cervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertility-preserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity...
September 2015: Revista do Colégio Brasileiro de Cirurgiões
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