Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, 2031, Australia.
J Cancer Surviv. 2019 Apr;13(2):269-281. doi: 10.1007/s11764-019-00749-x. Epub 2019 Apr 17.
Fertility treatments are available for women diagnosed with a gynecological malignancy, which is important for women who desire a biological family subsequent to treatment. The objective of this study was to report reproductive outcomes following fertility-sparing treatment for a gynaecological cancer.
Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy.
In total, 77 studies were included which reported on reproductive outcomes after treatment for cervical cancer, endometrial cancer, gestational trophoblastic disease, and ovarian cancer. The main treatments included vaginal or abdominal radical trachelectomy, progestin therapy, salpingo-oophorectomy, and chemotherapy. The mean age at diagnosis for the study population and at birth were 30.5 years and 30.3 years, respectively. There were 4749 pregnancies (42%) reported for the included studies, with a miscarriage rate of 15% and a medical termination rate of 5%. The live birth rate was 74% with a 10% preterm rate.
Patients should be offered timely discussions, information, and counseling regarding the impact of gynecological cancer treatment on a patient's fertility. Furthermore, fertility-sparing strategies and fertility preservation should be discussed prior to starting treatment.
对于被诊断出患有妇科恶性肿瘤的女性，可以采用生育力保留治疗方法，这对于治疗后希望组建有生物学关系的家庭的女性来说非常重要。本研究的目的是报告妇科癌症的生育力保留治疗后的生殖结局。
检索电子数据库，以确定报告妇科恶性肿瘤治疗后生殖结局的研究。
共纳入了 77 项研究，报告了宫颈癌、子宫内膜癌、妊娠滋养细胞疾病和卵巢癌治疗后的生殖结局。主要治疗方法包括阴道或腹部根治性子宫颈切除术、孕激素治疗、输卵管卵巢切除术和化疗。研究人群的平均诊断年龄和出生年龄分别为 30.5 岁和 30.3 岁。纳入研究报告了 4749 例妊娠（42%），流产率为 15%，医学终止妊娠率为 5%。活产率为 74%，早产率为 10%。
应及时向患者提供关于妇科癌症治疗对其生育力影响的讨论、信息和咨询。此外，在开始治疗前应讨论生育力保留策略和生育力保存。
