Tomao Federica, Di Pinto Anna, Sassu Carolina Maria, Bardhi Erlisa, Di Donato Violante, Muzii Ludovico, Petrella Maria Cristina, Peccatori Fedro Alessandro, Panici Pierluigi Benedetti
Department of Gynaecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, 00161 Rome, Italy.
Division of Gynaecologic Oncology, European Institute of Oncology, Milan, Italy.
Ecancermedicalscience. 2018 Dec 6;12:885. doi: 10.3332/ecancer.2018.885. eCollection 2018.
A considerable number of patients with a cancer diagnosis are of childbearing age and have not satisfied their desire for a family. Despite ovarian cancer (OC) usually occurring in older patients, 3%-14% are diagnosed at a fertile age with the overall 5-year survival rate being 91.2% in women ≤44 years of age when it is found at 1A-B stage. In this scenario, testing the safety and the efficacy of fertility sparing strategies in OC patients is very important overall in terms of quality of life. Unfortunately, the lack of randomised trials to validate conservative approaches does not guarantee the safety of fertility preservation strategies. However, evidence-based data from descriptive series suggest that in selected cases, the preservation of the uterus and at least one part of the ovary does not lead to a high risk of relapse. This conservative surgery helps to maintain organ function, giving patients of childbearing age the possibility to preserve their fertility. We hereby analysed the main evidence from the international literature on this topic in order to highlight the selected criteria for conservative management of OC patients, including healthy BRCA mutations carriers.
相当一部分被诊断患有癌症的患者处于育龄期，且尚未实现生育愿望。尽管卵巢癌（OC）通常发生在老年患者中，但仍有3%-14%的患者在育龄期被诊断出，当在1A-B期发现时，44岁及以下女性的总体5年生存率为91.2%。在这种情况下，从生活质量的总体角度来看，测试OC患者保留生育能力策略的安全性和有效性非常重要。不幸的是，缺乏验证保守方法的随机试验并不能保证生育力保存策略的安全性。然而，来自描述性系列的循证数据表明，在某些特定情况下，保留子宫和至少一部分卵巢不会导致高复发风险。这种保守手术有助于维持器官功能，使育龄期患者有可能保留生育能力。我们在此分析了国际文献中关于该主题的主要证据，以突出OC患者（包括携带健康BRCA突变者）保守治疗的选定标准。
