Abstract
Fertility preservation in women with ovarian tumours and ovarian cancer is a major challenge. Borderline ovarian tumours, malignant germ cell tumours and sex cord stromal tumours are tumour entities for which adequate surgical staging is recommended. In these tumours, fertility-sparing surgery is possible and should be considered in women with a wish to conceive after treatment. After thorough and individual counselling, women with epithelial invasive ovarian cancer can also be treated safely with fertility-sparing surgery if, after complete surgical staging, a tumour stage of FIGA IA G1/G2 is documented. Higher stages with epithelial ovarian cancer should not be treated with fertility-sparing surgery. Controlled hormonal stimulation and cryopreservation of oocytes may be recommended in individual cases. GnRH agonists for medical protection of the ovarian reserve are still under debate. All women should have surgical treatment completed after delivery.
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References
von Woff M, Dittrich R, Liebenthron J, Nawroth F, Schüring AN, Bruckner T, et al. Fertility preservation counselling and treatment for medical reasons: data from a multinational network of over 5000 women. Reprod Biomed Online. 2015;31:605–12. https://doi.org/10.1016/j.rbmo.2015.07.013.
Trillsch F, Mahner S, Woelber L, Vettorazzi E, Reuss A, Ewald-Riegler N, et al. Age-dependent differences in borderline ovarian tumours (BOT) regarding clinical characteristics and outcome: results from a sub-analysis of the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) ROBOT study. Ann Oncol. 2014;25:1320–7. https://doi.org/10.1093/annonc/mdu119.
Seong SJ, Kim DH, Kim MK, Song T. Controversies in borderline ovarian tumors. J Gynecol Oncol. 2015;26:343–9. https://doi.org/10.3802/jgo.2015.26.4.343.
https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/kid_2019/kid_2019_c56_eierstoecke.pdf?__blob=publicationFile, last retrieval 25.01.2020.
S3-Leitlinie. Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren, Langversion 3.0 2019, AWMF-Registernummer: 032/035OL. https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Ovarialkarzinom/Version_4/LL_Ovarialkarzinom_Langversion_4.01.pdf, last retrieval 26.01.2020.
Reid BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med. 2017;14:9–32. https://doi.org/10.20892/j.issn.2095-3941.2016.0084.
Park JY, Kim DY, Suh DS, Kim JH, Kim YM, et al. Outcomes of pediatric and adolescent girls with malignant ovarian germ cell tumors. Gynecol Oncol. 2015;137:418–22. https://doi.org/10.1016/j.ygyno.2015.03.054.
Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), Deutsche Gesellschaft für Reproduktionsmedizin (DGRM), Deutsche Gesellschaft für Urologie (DGU). Leitlinie: Fertilitätserhaltung bei onkologischen Therapien. Level S2k, AWMF Register Nr. 015/082, November 2017. http://www.awmf.org/leitlinien/detail/ll/015-082.html. Last retrieval 26.01.2020.
Ceppi L, Galli F, Lamanna M, Magni S, Dell’Orto F, Verri D, et al. Ovarian function, fertility, and menopause occurence after fertility-sparing surgery and chemotherapy for ovarian neoplasms. Gynecol Oncol. 2019;152:346–52. https://doi.org/10.1016/j.ygyno.2018.11.032.
Darai E, Fauvet R, Uzan C, Gouy S, Duvillard P, Morice P. Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options. Hum Reprod Update. 2013;19:151–66. https://doi.org/10.1093/annonc/mdt430.
Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzede C, Mustea A, Wimberger P, et al. The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications. Arch Gynecol Obstet. 2016;293:695–700. https://doi.org/10.1007/s00404-016-4035-8.
Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, et al. Maintenance Olaparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med. 2018;379:2495–505. https://doi.org/10.1056/NEJMoa1810858.
Ray-Coquard I, Pautier P, Pignata S, Perol D, Gonzales-Martin A, Berger R, PAOLA-1 Investigators. Olaparid plus Bevacizumab as first-line maintenance in ovarian cancer. N Engl J Med. 2019;381:2416–28. https://doi.org/10.1056/NEJMoa1911361.
Gadducci A, Lanfredini N, Tana R. Menstrual function and childbearing potential after fertility-sparing surgery and platinum-based chemotherapy for malignant ovarian germ cell tumours. Gynecol Endocrinol. 2014;30:467–71. https://doi.org/10.3109/09513590.2014.907262.
Fauvet R, Poncelet C, Boccara J, Descamps P, Fondrinier E, Darai E. Fertility after conservative treatment for borderline ovarian tumors: a French multicenter study. Fertil Steril. 2005;83:284–90. https://doi.org/10.1016/j.fertnstert.2004.10.009.
Wright JD, Shah M, Mathew L, Burke WM, Culhane J, Goldman N, Schiff PB, Herzog TJ. Fertility preservation in young women with epithelial ovarian cancer. Cancer. 2009;115:4118–26. https://doi.org/10.1002/cncr.24461.
Melamed A, Rizzo AE, Nitecki R, Gockley AA, Bregar AJ, Schorge JO, et al. All-cause mortality after fertility-sparing surgery for stage I epithelial ovarian cancer. Obstet Gynecol. 2017;130:71–9. https://doi.org/10.1097/AOG.0000000000002102.
Massarotti C, Scaruffi P, Lambertini M, Sozzi F, Remorgida V, Anserini P. Beyond fertility preservation: role of the oncofertility unit in the reproductive and gynecological follow-up of young cancer patients. Hum Reprod. 2019;34:1462–9. https://doi.org/10.1093/humrep/dez108.
Von Wolff M, Bruckner T, Strowitzki T, Germeyer A. Fertility preservation: ovarian response to freeze oocytes is not affected by different malignant diseases-an analysis of 992 stimulations. J Assist Reprod Genet. 2018;35:1713–9. https://doi.org/10.1007/s10815-018-1227-0.
Siristatidis C, Sergentanis TN, Kanavidis P, Trivella M, Sotiraki M, Mayromatis I, et al. Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis. Hum Reprod Update. 2013;19:105–23. https://doi.org/10.1093/humupd/dms051.
Denschlag D, von Wolff M, Amant F, Kesic V, Reed N, Schneider A, et al. Clinical recommendation on fertility preservation in borderline ovarian neoplasm: ovarian stimulation and oocyte retrieval after conservative surgery. Gynecol Obstet Investig. 2010;70:160–5. https://doi.org/10.1159/000316264.
Akel RA, Guo XM, Moravek MB, Confino R, Smith KN, et al. Ovarian stimulation is safe and effective for patients with gynecologic cancer. J Adolesc Young Adult Oncol. 2020; https://doi.org/10.1089/jayao.2019.0124.
Lin QY, Wang YV, Wenig HN, Sheng XJ, Jiang QP, Yang ZY. Influence of gonadotropin-releasing hormone agonist on the effect of chemotherapy upon ovarian cancer and the prevention of chemotherapy-induced ovarian damage. J Zhejiang Univ Sci B. 2012;13:894–903. https://doi.org/10.1631/jzus.B1100369.
Hauke J, Hahnen E, Schneider S, Reuss A, Richters L, Kommoss S, et al. Deleterious somatic variants in 473 consecutive individuals with ovarian cancer: results of the observational AGO-TR1 study (NCT02222883). J Med Genet. 2019;56:574–80. https://doi.org/10.1136/jmedgenet-2018-105930.
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Goeckenjan, M., Wimberger, P., von Wolff, M. (2020). Ovarian Tumours and Ovarian Cancer. In: von Wolff, M., Nawroth, F. (eds) Fertility Preservation in Oncological and Non-Oncological Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-47568-0_9
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DOI: https://doi.org/10.1007/978-3-030-47568-0_9
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