Schlegel Cameron, Copeland Amy R, Liebdzinski Michelle, Hall Lauren B, Myers Sara P, Holtzman Matthew P, Pingpank James F, Choudry Haroon A, Bartlett David L, Ongchin Melanie C
Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Division of Surgical Oncology, Koch Regional Perfusion Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Surg Res. 2025 Feb;306:122-128. doi: 10.1016/j.jss.2024.12.001. Epub 2025 Jan 4.
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is increasingly performed in young patients with peritoneal surface malignancies. Important quality of life (QoL) questions arise; however, there is limited research on fertility experiences in young women with carcinomatosis or following CRS/HIPEC.
Retrospective review of a prospective database evaluating women less than 45 ys who underwent CRS/HIPEC at the University of Pittsburgh Medical Center from January 1998 to 2020. Eligible patients were contacted for a telephone-based interview. Themes regarding fertility counseling, childbearing, and patient-identified issues were investigated.
A total of 28 of 29 women who met inclusion criteria participated. The majority had appendiceal primary (16/28). Most received Mitomycin C intraperitoneal chemotherapy (26/28) with an average Peritoneal Cancer Index of 8 (0-39). Almost half of the women (43%) desired fertility discussion. Although this conversation happened more often in younger patients, 75% were over the age of 35 ys at time of initial HIPEC. Less than half were offered fertility counseling. When fertility conversations occurred, many felt that they were insufficient. In addition to fertility, women cited lack of support on postprocedure hormonal and associated QoL changes.
As we treat younger females with CRS/HIPEC, we must provide support for age-appropriate QoL issues including fertility and surgical menopause.
细胞减灭术和腹腔内热灌注化疗（CRS/HIPEC）在患有腹膜表面恶性肿瘤的年轻患者中越来越多地被采用。重要的生活质量（QoL）问题随之而来；然而，关于患有癌性腹膜炎的年轻女性或接受CRS/HIPEC治疗后的生育经历的研究有限。
回顾性分析一个前瞻性数据库，该数据库评估了1998年1月至2020年在匹兹堡大学医学中心接受CRS/HIPEC治疗的45岁以下女性。符合条件的患者接受了电话访谈。调查了有关生育咨询、生育和患者确定的问题的主题。
符合纳入标准的29名女性中有28名参与。大多数患者的原发灶在阑尾（16/28）。大多数患者接受了丝裂霉素C腹腔内化疗（26/28），平均腹膜癌指数为8（0-39）。几乎一半的女性（43%）希望讨论生育问题。尽管这种谈话在年轻患者中更常发生，但75%的女性在初次接受HIPEC治疗时年龄超过35岁。不到一半的患者接受了生育咨询。当进行生育谈话时，许多人觉得谈话不够充分。除了生育问题，女性还提到在术后激素和相关生活质量变化方面缺乏支持。
在我们用CRS/HIPEC治疗年轻女性时，我们必须为与年龄相符的生活质量问题提供支持，包括生育和手术绝经。
