妇科恶性肿瘤保留生育功能肿瘤结局
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摘要
子宫颈癌、卵巢癌和子宫内膜癌是妇科常见的恶性肿瘤,近年发病有年轻化趋势。对于有生育要求的年轻患者,如何在不增加肿瘤风险的情况下,保留患者术后的生育功能,成为近年来备受关注的问题。文章对保留生育功能的妇科恶性肿瘤患者的肿瘤结局进行阐述。
Cervical cancer,ovarian cancer and endometrial carcinoma are most common maligancies in gynecology.More and more women suffer from gynecologic malignancies at a younger age.For these young women with hoping to preserve fertility,the fertilitysparing surgery without increasing the rise of tumor has been paid much attention.How are the oncological outcomes of these patients after the fertility-sparing surgeries ? We try to discuss this in the article.
Cervical cancer,ovarian cancer and endometrial carcinoma are most common maligancies in gynecology.More and more women suffer from gynecologic malignancies at a younger age.For these young women with hoping to preserve fertility,the fertilitysparing surgery without increasing the rise of tumor has been paid much attention.How are the oncological outcomes of these patients after the fertility-sparing surgeries ? We try to discuss this in the article.
引文
[1]Siegel RL,Miller KD,Jemal A.Cancer statistics[J].CA Cancer JClin,2015,65(1):5-29.
[2]Arbyn M,Autier P,Ferlay J,et al.Burden of cervical cancer in the 27 member states of the European Union:estimates for2004[J].Ann Oncol,2007,18:1423-1425.
[3]Watson M,Saraiya M,Benard V,et al.Burden of cervical cancer in the United States,1998-2003[J].Cancer,2008,113:2855-2864.
[4]Koh WJ,Abu-Rustum NR,Bean S,et al.Cervical Cancer,Version 3.2019,NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw,2019,17:64-84.
[5]Al-Kalbani M,McVeigh G,Nagar H,et al.Do FIGO stage IAand small( [6]Pluta M,Rob L,Charvat M,et al.Less radical surgery than radical hysterectomy in early stage cervical cancer:a pilot study[J].Gynecol Oncol,2009,113:181-184.
[7]Slama J,Cerny A,Dusek L,et al.Results of less radical fertilitysparing procedures with omitted parametrectomy for cervical cancer:5 years of experience[J].Gynecol Oncol,2016,142:401-404.
[8]Lindsay R,Burton K,Shanbhag S,et al.Fertility conserving management of early cervical cancer:our experience of LLETZ and pelvic lymph node dissection[J].Int J Gynecol Cancer,2014,24:118-123.
[9]Dargent D,Burn JL,Roy M,et al.Pregnancies following radical trachelectomy for invasive cervical cancer[J].Gynecol Oncol,1994,52:105.
[10]Marchiole P,Benchaib M,Buenerd A,et al.Oncological safety of laparoscopic-assisted vaginal radical trachelectomy(LARVT or Dargent’s operation):a comparative study with laparoscopic-assisted vaginal radical hysterectomy(LARVH)[J].Gynecol Oncol,2007,106:132-141.
[11]Plante M,Gregoire J,Renaud MC,et al.The vaginal radical trachelectomy:an update of a series of 125 cases and 106 pregnancies[J].Gynecol Oncol,2011,121:290-297.
[12]Lintner B,Saso S,Tarnai L,et al.Use of abdominal radical trachelectomy to treat cervical cancer greater than 2 cm in diameter[J].Int J Gynecol Cancer,2013,23:1065-1070.
[13]Diaz JP,Sonoda Y,Leitao MM,et al.Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma[J].Gynecol Oncol,2008,111:255-260.
[14]Bentivegna E,Gouy S,Maulard A,et al.Oncological outcomes after fertility-sparing surgery for cervical cancer:a systematic review[J].Lancet Oncol,2016,17:e240-e253.
[15]Rob L,Skapa P.Fertility-sparing surgery in patients with cervical cancer[J].Lancet Oncol,2011,12:192-200.
[16]Kim HS,Sardi JE,Katsumata N,et al.Efficacy of neoadjuvant chemotherapy in patients with FIGO stageⅠB1 toⅡA cervical cancer:an international collaborative meta-analysis[J].Eur JSurg Oncol,2013,39:115-124.
[17]Gong L,Lou JY,Wang P,et al.Clinical evaluation of neoadjuvant chemotherapy followed by radical surgery in the management of stage IB2-ⅡB cervical cancer[J].Int J Gynaecol Obstet,2012,117:23-26.
[18]Katsumata N,Yoshikawa H,Kobayashi H,et al.PhaseⅡI randomised controlled trial of neoadjuvant chemotherapy plus radical surgery vs radical surgery alone for stages IB2,ⅡA2,andⅡB cervical cancer:a Japan Clinical Oncology Group trial(JCOG 0102)[J].Br J Cancer,2013,108:1957-1963.
[19]Arora RS,Alston RD,Eden TO,et al.Comparative incidence patterns and trends of gonadal and extragonadal germ cell tumors in England,1979 to 2003[J].Cancer,2012,118(17):4290-4297.
[20]Di Tucci C,Casorelli A,Morrocchi E,et al.Fertility management for malignant ovarian germ cell tumors patients[J].Crit Rev Oncol Hematol,2017,120:34-42.
[21]Turkmen O,Karalok A,Basaran D,et al.Fertility-Sparing Surgery Should Be the Standard Treatment in Patients with Malignant Ovarian Germ Cell Tumors[J].J Adolesc Young Adult Oncol,2017,6:270-276.
[22]Nasioudis D,Frey MK,Chapman-Davis E,et al.Fertility-preserving surgery for advanced stage ovarian germ cell tumors[J].Gynecol Oncol,2017,147:493-496.
[23]Siegel RL,Miller KD,Jemal A.Cancer Statistics,2017[J].CACancer J Clin,2017,67:7-30.
[24]Fruscio R,Ceppi L,Corso S,et al.Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer[J].Br J Cancer,2016,115:641-648.
[25]Jiang X,Yang J,Yu M,et al.Oncofertility in patients with stage I epithelial ovarian cancer:fertility-sparing surgery in young women of reproductive age[J].World J Surg Oncol,2017,15:154.
[26]Hedb?ck NE,Karlsen MA,H?gdall CK.Survival of selected patients with ovarian cancer treated with fertility-sparing surgery[J].Reprod Biomed Online,2018,37:71-76.
[27]Ledermann JA,Raja FA,Fotopoulou C,et al.Newly diagnosed and relapsed epithelial ovarian carcinoma:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2018,29:259.
[28]Kajiyama H,Shibata K,Mizuno M,et al.Fertility-sparing surgery in patients with clear-cell carcinoma of the ovary:is it possible?[J].Hum Reprod,2011,26:3297-3302.
[29]Ureyen I,Karalok A,Tasci T,et al.The factors predicting recurrence in patients with serous borderline ovarian tumor[J].Int JGynecol Cancer,2016,26:66-72.
[30]Simon B,Lee SJ,Partridge AH.Preserving fertility after cancer[J].CA Cancer J Clin,2005,55:211-228.
[31]Zanetta G,Rota S,Chiari S,et al.Behavior of borderline tumors with particular interest to persistence,recurrence,and progression to invasive carcinoma:a prospective study[J].J Clin Oncol,2001,19:2658-2664.
[32]Trillsch F,Mahner S,Woelber L,et al.Age-dependent differences in borderline ovarian tumours(borderline ovarian tumor)regarding clinical characteristics and outcome:results from a sub-analysis of the Arbeitsgemeinschaft Gynaekologische Onkologie(AGO)RO borderline ovarian tumor study[J].Ann Oncol,2014,25:1320-1327.
[33]Zanetta G,Rota S,Chiari S,et al.Behavior of borderline tumors with particular interest to persistence,recurrence,and progression to invasive carcinoma:a prospective study[J].J Clin Oncol,2001,19:2658-2664.
[34]Loizzi V,Selvaggi L,Leone L,et al.Borderline epithelial tumors of the ovary:experience of 55 patients[J].Oncol Lett,2015,9:912-914.
[35]Helpman L,Yaniv A,Beiner ME,et al.Fertility preservation in women with borderline ovarian tumors-how does it impact disease outcome?A cohort study[J].Acta Obstet Gynecol Scand,2017,96:1300-1306.
[36]Trillsch F,Mahner S,Vettorazzi E,et al.Surgical staging and prognosis in serous borderline ovarian tumours(BOT):a subanalysis of the AGO ROBOT study[J].Br J Cancer,2015,112:660-666.
[37]Shih KK,Zhou Q,Huh J,et al.Risk factors for recurrence of ovarian borderline tumors[J].Gynecol Oncol,2011,120(3):480-484.
[38]Chen RF,Li J,Zhu TT,et al.Fertility-sparing surgery for young patients with borderline ovarian tumors(BOTs):single institution experience[J].J Ovarian Res,2016,9:16.
[39]Morgan RJ,Armstrong DK,Alvarez RD,et al.Ovarian Cancer,Version 1.2016,NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw,2016,14:1134-1163.
[40]朱瑜苑,王刚.左炔诺孕酮宫内缓释系统在子宫内膜癌保留生育功能治疗中的应用[J].中国实用妇科与产科杂志,2017,33(12):1296-1299.
[41]张师前,于浩.年轻早期子宫内膜癌保留生育功能治疗[J].中国实用妇科与产科杂志,2017,33(5):458-461.
[42]Koh WJ,Abu-Rustum NR,Bean S,et al.Uterine Neoplasms,Version 1.2018,NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw,2018,16:170-199.
[43]Ruiz MP,Huang Y,Hou JY,et al.All-cause mortality in young women with endometrial cancer receiving progesterone therapy[J].Am J Obstet Gynecol,2017,217:669.e1-13.
[44]Greenwald ZR,Huang LN,Wissing MD,et al.Does hormonal therapy for fertility preservation affect the survival of young women with early-stage endometrial cancer?[J].Cancer,2017,123:1545-1554.
[45]Minig L,Franchi D,Boveri S,et al.Progestin intrauterine device and GnRH analogue for uterus-sparing treatment of endometrial precancers and well-differentiated early endometrial carcinoma in young women[J].Ann Oncol,2011,22:643-649.
[46]Giampaolino P,Di Spiezio SA,Mollo A,et al.Hysteroscopic Endometrial Focal Resection followed by Levonorgestrel Intrauterine Device Insertion as a Fertility-Sparing Treatment of Atypical Endometrial Hyperplasia and Early Endometrial Cancer:ARetrospective Study[J].J Minim Invasive Gynecol,2018,pⅡ:S1553-4650(18)30347-30349.
[47]Falcone F,Laurelli G,Losito S,et al.Fertility preserving treatment with hysteroscopic resection followed by progestin therapy in young women with early endometrial cancer[J].J Gynecol Oncol,2017,28:e2.2019-02-12
[2]Arbyn M,Autier P,Ferlay J,et al.Burden of cervical cancer in the 27 member states of the European Union:estimates for2004[J].Ann Oncol,2007,18:1423-1425.
[3]Watson M,Saraiya M,Benard V,et al.Burden of cervical cancer in the United States,1998-2003[J].Cancer,2008,113:2855-2864.
[4]Koh WJ,Abu-Rustum NR,Bean S,et al.Cervical Cancer,Version 3.2019,NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw,2019,17:64-84.
[5]Al-Kalbani M,McVeigh G,Nagar H,et al.Do FIGO stage IAand small( [6]Pluta M,Rob L,Charvat M,et al.Less radical surgery than radical hysterectomy in early stage cervical cancer:a pilot study[J].Gynecol Oncol,2009,113:181-184.
[7]Slama J,Cerny A,Dusek L,et al.Results of less radical fertilitysparing procedures with omitted parametrectomy for cervical cancer:5 years of experience[J].Gynecol Oncol,2016,142:401-404.
[8]Lindsay R,Burton K,Shanbhag S,et al.Fertility conserving management of early cervical cancer:our experience of LLETZ and pelvic lymph node dissection[J].Int J Gynecol Cancer,2014,24:118-123.
[9]Dargent D,Burn JL,Roy M,et al.Pregnancies following radical trachelectomy for invasive cervical cancer[J].Gynecol Oncol,1994,52:105.
[10]Marchiole P,Benchaib M,Buenerd A,et al.Oncological safety of laparoscopic-assisted vaginal radical trachelectomy(LARVT or Dargent’s operation):a comparative study with laparoscopic-assisted vaginal radical hysterectomy(LARVH)[J].Gynecol Oncol,2007,106:132-141.
[11]Plante M,Gregoire J,Renaud MC,et al.The vaginal radical trachelectomy:an update of a series of 125 cases and 106 pregnancies[J].Gynecol Oncol,2011,121:290-297.
[12]Lintner B,Saso S,Tarnai L,et al.Use of abdominal radical trachelectomy to treat cervical cancer greater than 2 cm in diameter[J].Int J Gynecol Cancer,2013,23:1065-1070.
[13]Diaz JP,Sonoda Y,Leitao MM,et al.Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma[J].Gynecol Oncol,2008,111:255-260.
[14]Bentivegna E,Gouy S,Maulard A,et al.Oncological outcomes after fertility-sparing surgery for cervical cancer:a systematic review[J].Lancet Oncol,2016,17:e240-e253.
[15]Rob L,Skapa P.Fertility-sparing surgery in patients with cervical cancer[J].Lancet Oncol,2011,12:192-200.
[16]Kim HS,Sardi JE,Katsumata N,et al.Efficacy of neoadjuvant chemotherapy in patients with FIGO stageⅠB1 toⅡA cervical cancer:an international collaborative meta-analysis[J].Eur JSurg Oncol,2013,39:115-124.
[17]Gong L,Lou JY,Wang P,et al.Clinical evaluation of neoadjuvant chemotherapy followed by radical surgery in the management of stage IB2-ⅡB cervical cancer[J].Int J Gynaecol Obstet,2012,117:23-26.
[18]Katsumata N,Yoshikawa H,Kobayashi H,et al.PhaseⅡI randomised controlled trial of neoadjuvant chemotherapy plus radical surgery vs radical surgery alone for stages IB2,ⅡA2,andⅡB cervical cancer:a Japan Clinical Oncology Group trial(JCOG 0102)[J].Br J Cancer,2013,108:1957-1963.
[19]Arora RS,Alston RD,Eden TO,et al.Comparative incidence patterns and trends of gonadal and extragonadal germ cell tumors in England,1979 to 2003[J].Cancer,2012,118(17):4290-4297.
[20]Di Tucci C,Casorelli A,Morrocchi E,et al.Fertility management for malignant ovarian germ cell tumors patients[J].Crit Rev Oncol Hematol,2017,120:34-42.
[21]Turkmen O,Karalok A,Basaran D,et al.Fertility-Sparing Surgery Should Be the Standard Treatment in Patients with Malignant Ovarian Germ Cell Tumors[J].J Adolesc Young Adult Oncol,2017,6:270-276.
[22]Nasioudis D,Frey MK,Chapman-Davis E,et al.Fertility-preserving surgery for advanced stage ovarian germ cell tumors[J].Gynecol Oncol,2017,147:493-496.
[23]Siegel RL,Miller KD,Jemal A.Cancer Statistics,2017[J].CACancer J Clin,2017,67:7-30.
[24]Fruscio R,Ceppi L,Corso S,et al.Long-term results of fertility-sparing treatment compared with standard radical surgery for early-stage epithelial ovarian cancer[J].Br J Cancer,2016,115:641-648.
[25]Jiang X,Yang J,Yu M,et al.Oncofertility in patients with stage I epithelial ovarian cancer:fertility-sparing surgery in young women of reproductive age[J].World J Surg Oncol,2017,15:154.
[26]Hedb?ck NE,Karlsen MA,H?gdall CK.Survival of selected patients with ovarian cancer treated with fertility-sparing surgery[J].Reprod Biomed Online,2018,37:71-76.
[27]Ledermann JA,Raja FA,Fotopoulou C,et al.Newly diagnosed and relapsed epithelial ovarian carcinoma:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2018,29:259.
[28]Kajiyama H,Shibata K,Mizuno M,et al.Fertility-sparing surgery in patients with clear-cell carcinoma of the ovary:is it possible?[J].Hum Reprod,2011,26:3297-3302.
[29]Ureyen I,Karalok A,Tasci T,et al.The factors predicting recurrence in patients with serous borderline ovarian tumor[J].Int JGynecol Cancer,2016,26:66-72.
[30]Simon B,Lee SJ,Partridge AH.Preserving fertility after cancer[J].CA Cancer J Clin,2005,55:211-228.
[31]Zanetta G,Rota S,Chiari S,et al.Behavior of borderline tumors with particular interest to persistence,recurrence,and progression to invasive carcinoma:a prospective study[J].J Clin Oncol,2001,19:2658-2664.
[32]Trillsch F,Mahner S,Woelber L,et al.Age-dependent differences in borderline ovarian tumours(borderline ovarian tumor)regarding clinical characteristics and outcome:results from a sub-analysis of the Arbeitsgemeinschaft Gynaekologische Onkologie(AGO)RO borderline ovarian tumor study[J].Ann Oncol,2014,25:1320-1327.
[33]Zanetta G,Rota S,Chiari S,et al.Behavior of borderline tumors with particular interest to persistence,recurrence,and progression to invasive carcinoma:a prospective study[J].J Clin Oncol,2001,19:2658-2664.
[34]Loizzi V,Selvaggi L,Leone L,et al.Borderline epithelial tumors of the ovary:experience of 55 patients[J].Oncol Lett,2015,9:912-914.
[35]Helpman L,Yaniv A,Beiner ME,et al.Fertility preservation in women with borderline ovarian tumors-how does it impact disease outcome?A cohort study[J].Acta Obstet Gynecol Scand,2017,96:1300-1306.
[36]Trillsch F,Mahner S,Vettorazzi E,et al.Surgical staging and prognosis in serous borderline ovarian tumours(BOT):a subanalysis of the AGO ROBOT study[J].Br J Cancer,2015,112:660-666.
[37]Shih KK,Zhou Q,Huh J,et al.Risk factors for recurrence of ovarian borderline tumors[J].Gynecol Oncol,2011,120(3):480-484.
[38]Chen RF,Li J,Zhu TT,et al.Fertility-sparing surgery for young patients with borderline ovarian tumors(BOTs):single institution experience[J].J Ovarian Res,2016,9:16.
[39]Morgan RJ,Armstrong DK,Alvarez RD,et al.Ovarian Cancer,Version 1.2016,NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw,2016,14:1134-1163.
[40]朱瑜苑,王刚.左炔诺孕酮宫内缓释系统在子宫内膜癌保留生育功能治疗中的应用[J].中国实用妇科与产科杂志,2017,33(12):1296-1299.
[41]张师前,于浩.年轻早期子宫内膜癌保留生育功能治疗[J].中国实用妇科与产科杂志,2017,33(5):458-461.
[42]Koh WJ,Abu-Rustum NR,Bean S,et al.Uterine Neoplasms,Version 1.2018,NCCN Clinical Practice Guidelines in Oncology[J].J Natl Compr Canc Netw,2018,16:170-199.
[43]Ruiz MP,Huang Y,Hou JY,et al.All-cause mortality in young women with endometrial cancer receiving progesterone therapy[J].Am J Obstet Gynecol,2017,217:669.e1-13.
[44]Greenwald ZR,Huang LN,Wissing MD,et al.Does hormonal therapy for fertility preservation affect the survival of young women with early-stage endometrial cancer?[J].Cancer,2017,123:1545-1554.
[45]Minig L,Franchi D,Boveri S,et al.Progestin intrauterine device and GnRH analogue for uterus-sparing treatment of endometrial precancers and well-differentiated early endometrial carcinoma in young women[J].Ann Oncol,2011,22:643-649.
[46]Giampaolino P,Di Spiezio SA,Mollo A,et al.Hysteroscopic Endometrial Focal Resection followed by Levonorgestrel Intrauterine Device Insertion as a Fertility-Sparing Treatment of Atypical Endometrial Hyperplasia and Early Endometrial Cancer:ARetrospective Study[J].J Minim Invasive Gynecol,2018,pⅡ:S1553-4650(18)30347-30349.
[47]Falcone F,Laurelli G,Losito S,et al.Fertility preserving treatment with hysteroscopic resection followed by progestin therapy in young women with early endometrial cancer[J].J Gynecol Oncol,2017,28:e2.2019-02-12