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截至2023年日本生育力保存治疗的趋势:日本肿瘤生育登记处分析

Trends in fertility preservation treatments in Japan until 2023: analysis of the Japan Oncofertility Registry.

作者信息

Kawai Takao, Harada Miyuki, Urata Yoko, Sanada Yuko, Kaneda Youtaro, Takai Yasushi, Osuga Yutaka, Suzuki Nao

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo, 113-8655, Japan.

Division of Reproductive Medicine, Department of Perinatal and Maternal Care, National Center for Child Health and Development, Tokyo, Japan.

出版信息

Int J Clin Oncol. 2025 Apr;30(4):684-695. doi: 10.1007/s10147-025-02725-1. Epub 2025 Feb 28.

Abstract

BACKGROUND

Fertility preservation for patients with cancer or other diseases who receive gonadotoxic treatment has gained importance as cancer survival rates increase. In Japan, a database for registering all fertility preservation patients, named the Japan Oncofertility Registry (JOFR), was established in 2018. This study aimed to analyze recent trends in fertility preservation in Japan utilizing data from the JOFR.

METHODS

Data was extracted from the JOFR for patients who consulted fertility preservation teams until May 2024. A descriptive analysis was conducted to examine trends in patient demographics, cancer types, fertility preservation treatments, complications, and outcomes. The data covered the period from diagnosis to fertility preservation and subsequent usage or disposal of frozen specimens.

RESULTS

A total of 11,510 patients were recorded, with 9491 undergoing fertility preservation treatments. The number of patients increased steadily after 2006. After 2021, the number of female patients was much higher than the number of male patients. The most common primary diseases were breast cancer among women and testicular tumors and leukemia among men. There were some complications including ovarian hyperstimulation syndrome (5.0%), bleeding (0.12%), and infections (0.05%) for women. Seven hundred and sixty clinical pregnancies were recorded, with 440 using preserved specimens. The discard rate was 16.3% for men and 3.7% for women.

CONCLUSION

The study highlights recent trends in the growing number of cases undergoing fertility preservation in Japan. It also identifies several issues to be solved in fertility preservation in Japan, regarding its efficacy and safety, as well as the medical provision system.

摘要

背景

随着癌症生存率的提高,为接受性腺毒性治疗的癌症或其他疾病患者保留生育能力变得愈发重要。在日本,一个名为日本肿瘤生育登记处(JOFR)的登记所有生育力保存患者的数据库于2018年建立。本研究旨在利用JOFR的数据分析日本生育力保存的近期趋势。

方法

从JOFR中提取了截至2024年5月咨询生育力保存团队的患者数据。进行了描述性分析,以研究患者人口统计学、癌症类型、生育力保存治疗、并发症和结果的趋势。数据涵盖了从诊断到生育力保存以及随后冷冻标本的使用或处置的时间段。

结果

共记录了11510名患者,其中9491名接受了生育力保存治疗。2006年后患者数量稳步增加。2021年后,女性患者数量远高于男性患者。最常见的原发性疾病在女性中是乳腺癌,在男性中是睾丸肿瘤和白血病。女性存在一些并发症,包括卵巢过度刺激综合征(5.0%)、出血(0.12%)和感染(0.05%)。记录了760例临床妊娠,其中440例使用了保存的标本。男性的丢弃率为16.3%,女性为3.7%。

结论

该研究突出了日本接受生育力保存的病例数量不断增加的近期趋势。它还确定了日本生育力保存在疗效和安全性以及医疗供应系统方面有待解决的几个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab74/11947001/4f4bacc469fc/10147_2025_2725_Fig1_HTML.jpg

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