Bergamini Alice, Petrone Micaela, Rabaiotti Emanuela, Pella Francesca, Cioffi Raffaella, Rossi Elena Giulia, Di Mattei Valentina, Candiani Massimo, Mangili Giorgia
a Department of Obstetrics and Gynecology , IRCCS San Raffaele Hospital , Milan , Italy.
b Faculty of Psychology , Vita-Salute San Raffaele University , Milan , Italy.
Gynecol Endocrinol. 2018 Apr;34(4):305-308. doi: 10.1080/09513590.2017.1393508. Epub 2017 Oct 26.
About 2.7% of patients epithelial ovarian cancers (EOC) are younger than 40 and present with stage I disease. For this subset of women, the issue of fertility sparing surgery (FSS) has become critical. The aim of this survey was to investigate the management of EOC patients desiring to preserve fertility in Italy. A questionnaire consisting of 30 items was developed to evaluate: patient-selection criteria, rate of FSS, patient's counseling- and pregnancy-timing, fertility preservation, obstetrics, and oncologic outcomes. One expert clinician for each of 50 major gynecologic oncology centers was invited to participate. Data were entered into a database and statistically analyzed. 74% of questionnaires were complete. The proportion of EOC patients treated with FSS was <10%, 10%-20% and >20% in 70.3%, 24.3% and 5.4% of cases, respectively. Age, fertility preservation desire, histotype, and stage were considered relevant to select patients for a conservative treatment for 64.8%, 72.9%, and 78.3% of responders, respectively. Only 17 centers (45.9%) resulted to have an assisted reproductive technique service and Obstetrics Department. Our survey highlights discrepancies among oncologists in the management of patients with early EOC undergoing FSS. More efforts should be made to define and broadcast the best management before and after surgery.
约2.7%的上皮性卵巢癌（EOC）患者年龄小于40岁，且为Ⅰ期疾病。对于这部分女性患者，保留生育功能手术（FSS）问题变得至关重要。本调查旨在研究意大利有生育意愿的EOC患者的治疗情况。设计了一份包含30个条目的问卷，以评估：患者选择标准、FSS比例、患者咨询及妊娠时机、生育力保存、产科情况和肿瘤学结局。邀请了50个主要妇科肿瘤中心的每位一名专家临床医生参与。数据录入数据库并进行统计学分析。74%的问卷填写完整。接受FSS治疗的EOC患者比例分别在70.3%、24.3%和5.4%的病例中<10%、10%-20%和>20%。年龄、生育力保存意愿、组织学类型和分期分别被64.8%、72.9%和78.3%的受访者认为与选择保守治疗患者相关。只有17个中心（45.9%）设有辅助生殖技术服务和产科。我们的调查突出了肿瘤学家在对接受FSS的早期EOC患者的管理方面存在差异。应做出更多努力来明确并宣传手术前后的最佳管理方法。
