Gynecologic Oncology Unit, Donostia University Hospital, San Sebastián, Spain.
Gynecologic Oncology Unit, Hospital Clinic, Barcelona, Spain.
Arch Gynecol Obstet. 2020 Mar;301(3):793-800. doi: 10.1007/s00404-020-05468-8. Epub 2020 Mar 2.
To analyze the current management and use of fertility preservation (FP) treatments among different gynecologic oncology centers in Spain METHODS: From March to April 2019, a transversal study was conducted using a national online survey to consultants registered in the section of Gynecologic Oncology of the Spanish Society of Obstetrics and Gynecology. The survey contained 30 questions that assessed the perceptions and attitudes towards fertility-sparing strategies as well as its management in each participating center.
A total of 51 responders from 12 out of 17 geographical regions of Spain answered the survey. According to 35 responders (68.63%), the age limit for offering FP was 40 years. In most of the centers, an ovarian reserve study is carried out prior to a FP procedure (34 responders, 66.67%). In cervical cancer size, limit for offering trachelectomy is 2 cm (40 responders, 78.43%), with LVSI as an exclusion factor for 26 (51%). Twenty-four (48.98%) responders reported that FP only in ovarian cancer stages IA, 12 (24.49%) also in stages IB, and an additional 13 (26.53%) up to stages IC. Most responders perform FP only in the absence of myometrial infiltration (30, 58.82%) in patients with g1-g2 endometrial cancer.
The performance of professionals at the national level is uneven, demonstrating the need for referral centers to ensure optimal management. International guidelines should be more widely extended throughout Spain to homogenize the treatment of young oncology patients who wish to have children.
分析西班牙不同妇科肿瘤中心目前对生育力保存（FP）治疗的管理和应用情况。
2019 年 3 月至 4 月，采用全国性在线调查对西班牙妇产科协会妇科肿瘤学分会注册顾问进行了一项横断面研究。该调查包含 30 个问题，评估了对生育力保留策略的看法和态度，以及每个参与中心对其的管理。
来自西班牙 17 个地理区域中的 12 个区域的 51 名应答者回答了调查。根据 35 名应答者（68.63%）的说法，提供 FP 的年龄限制为 40 岁。在大多数中心，在进行 FP 程序之前会进行卵巢储备研究（34 名应答者，66.67%）。在宫颈癌大小方面，提供子宫颈切除术的限制为 2cm（40 名应答者，78.43%），有 26 名（51%）将 LVSI 作为排除因素。24 名（48.98%）应答者报告称仅在卵巢癌 IA 期提供 FP，12 名（24.49%）还在 IB 期提供，另外 13 名（26.53%）直至 IC 期。大多数应答者仅在子宫内膜癌 g1-g2 患者中没有肌层浸润时才进行 FP（30 名，58.82%）。
国家层面专业人员的表现参差不齐，表明需要转诊中心以确保进行最佳管理。应更广泛地在西班牙推广国际指南，以统一希望生育的年轻肿瘤患者的治疗方法。
