Florida Hospital Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, 32804, USA.
Florida Hospital Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, 32804, USA.
Crit Rev Oncol Hematol. 2018 Dec;132:116-124. doi: 10.1016/j.critrevonc.2018.09.020. Epub 2018 Oct 4.
Gynecological malignancies affect significant proportion of women in whom fertility preservation is a priority. Advancing reproductive technology and modern surgical techniques are changing the way young women with cancer are counseled regarding their fertility plans at time of cancer diagnosis. This review article provides the reader with fertility preserving updates in gynecologic malignancies as well as those with genetic predisposition for gynecologic malignancies. The different types of gynecologic malignancies including cervical, endometrial, and ovarian cancers and their unique obstacles are addressed separately. New insights into conservative cervical cancer surgery and fertility preserving neoadjuvant chemotherapy followed by fertility preserving surgery for cervical cancer are discussed. Hormonal management of endometrial cancer are highlighted. Additionally, better understanding of ovarian failure with modern chemotherapy/radiation therapy is summarized. Finally, modern reproductive techniques such as ovarian cryopreservation are reviewed as well as those in early stages are development such as artificial ovarian tissue are previewed.
妇科恶性肿瘤影响了相当一部分女性，其中生育力保存是重中之重。生殖技术的进步和现代外科技术正在改变癌症诊断时对患有癌症的年轻女性进行生育计划咨询的方式。本文综述了妇科恶性肿瘤以及具有妇科恶性肿瘤遗传倾向的患者的生育力保存的最新进展。分别讨论了不同类型的妇科恶性肿瘤，包括宫颈癌、子宫内膜癌和卵巢癌及其独特的障碍。讨论了保留生育功能的宫颈癌新辅助化疗后行保留生育功能手术的保守性宫颈癌手术和保留生育功能的新见解。强调了子宫内膜癌的激素管理。此外，总结了对现代化疗/放疗引起的卵巢衰竭的更好理解。最后，综述了卵巢冷冻等现代生殖技术，以及正在开发的早期人工卵巢组织等技术。
