Gynecologic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II" Bari, Italy.
Institutional BioBank, Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori "Giovanni Paolo II," Bari, Italy.
Medicine (Baltimore). 2022 Apr 29;101(17):e29163. doi: 10.1097/MD.0000000000029163.
The usefulness of this review is to highlight how a fertility preservation (FP) approach is currently feasible for patients diagnosed with uterine cervical cancer. To this regard, a fertility sparing surgery has just overcome its traditional limits, gained acceptance within the major gynecologic oncology societies thanks to the ability to identify the "ideal" candidates to this conservative treatment. On the other hand, the use of other FPs for oocyte and ovarian cortex cryopreservation is still extremely debated. In fact, the existing risk of tumor spreading during oocyte retrieval necessary for oocyte cryostorage for patients' candidates for neo-adjuvant therapy, as well as the potential hazard of cancer cell dissemination after ovarian tissue replacement in cases of non-squamous type cervical carcinomas should not be underestimated. Therefore, in consideration of the encountered limitations and the need to ensure adequate reproductive health for young uterine cervical cancer survivors, translational research regarding the FP has progressively collected innovative insights into the employment of stemness technology. In this context, the property of ovarian stem cells obtained from the ovarian cortex to generate functional oocytes in women could represent a promising therapeutic alternative to the current procedures for a novel and safer FP approach in cancer survivors.
本综述的目的是强调目前针对子宫颈癌患者的生育力保存（FP）方法的实用性。在这方面，保留生育力手术刚刚克服了其传统限制，由于能够确定“理想”的候选人接受这种保守治疗，已得到主要妇科肿瘤学会的认可。另一方面，卵母细胞和卵巢皮质冷冻保存等其他 FP 的使用仍存在很大争议。事实上，对于新辅助治疗候选患者的卵母细胞冷冻保存，卵母细胞采集过程中存在肿瘤扩散的风险，对于非鳞状宫颈癌患者，卵巢组织替代后癌细胞播散的潜在危险也不容忽视。因此，考虑到所遇到的限制以及为确保年轻子宫颈癌幸存者获得足够的生殖健康，关于 FP 的转化研究已经逐步为利用干性技术提供了新的见解。在这种情况下，从卵巢皮质中获得的卵巢干细胞具有生成功能性卵母细胞的特性，这可能为癌症幸存者提供一种有前途的治疗替代方案，以替代当前的 FP 方法。
