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宫颈癌保留生育功能治疗后的生殖和产科结局:当前方法与未来方向

Reproductive and Obstetric Outcomes after Fertility-Sparing Treatments for Cervical Cancer: Current Approach and Future Directions.

作者信息

Terzic Milan, Makhadiyeva Dinara, Bila Jovan, Andjic Mladen, Dotlic Jelena, Aimagambetova Gulzhanat, Sarria-Santamera Antonio, Laganà Antonio Simone, Chiantera Vito, Vukovic Ivana, Kocijancic Belovic Dusica, Aksam Slavica, Bapayeva Gauri, Terzic Sanja

机构信息

Department of Surgery, School of Medicine, Nazarbayev University, Zhanybek-Kerey Khans Street, 5/1, Astana 010000, Kazakhstan.

Clinical Academic Department of Women's Health, National Research Center for Maternal and Child Health, Corporate Fund "University Medical Center", Turan Ave. 32, Astana 010000, Kazakhstan.

出版信息

J Clin Med. 2023 Mar 30;12(7):2614. doi: 10.3390/jcm12072614.

Abstract

Cervical cancer is one of the leading causes of cancer-related death in women of reproductive age. The established fertility-sparing approaches for the management of early-stage cervical cancer for women who plan pregnancy are associated with a decline in fecundity and an increased risk of pregnancy complications. This article aims to offer an overview of fertility-sparing approaches and the management of potential subfertility and pregnancy complications after these treatments. An extensive search for the available data about infertility and cervical cancer, fertility-sparing techniques in patients with cervical cancer, fertility treatment, obstetrical complications, and pregnancy outcomes in cervical cancer patients was completed. Fertility-preserving procedures such as loop electrosurgical excision procedure (LEEP), cold-knife conization, and trachelectomy in women diagnosed with cervical cancer can be considered as safe and effective treatments that preserve reproductive potential. Current fertility-preserving procedures, based on the balance of the oncological characteristics of patients as well as their desire for reproduction, allow one to obtain acceptable reproductive and obstetric outcomes in women treated for cervical cancer. Nevertheless, careful monitoring of pregnancies obtained after fertility-preserving procedures is recommended, since this cohort of patients should be considered at higher risk compared with a healthy population.

摘要

宫颈癌是育龄期女性癌症相关死亡的主要原因之一。对于计划怀孕的早期宫颈癌女性,已确立的保留生育功能的治疗方法与生育力下降及妊娠并发症风险增加有关。本文旨在概述保留生育功能的方法以及这些治疗后潜在的生育力低下和妊娠并发症的管理。我们广泛检索了有关不孕症与宫颈癌、宫颈癌患者的保留生育功能技术、生育治疗、产科并发症以及宫颈癌患者妊娠结局的现有数据。对于被诊断为宫颈癌的女性,诸如环形电切术(LEEP)、冷刀锥切术和宫颈切除术等保留生育功能的手术可被视为保留生殖潜能的安全有效治疗方法。当前的保留生育功能手术,基于患者肿瘤学特征及其生育意愿的平衡,能使接受宫颈癌治疗的女性获得可接受的生殖和产科结局。然而,建议对保留生育功能手术后的妊娠进行仔细监测,因为与健康人群相比,这组患者应被视为具有更高风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc03/10095321/248675803344/jcm-12-02614-g001.jpg

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