tailieunhanh - Fertility Sparing Treatments in Young Patients with Gynecological Cancers: Iranian Experience and Literature Review

The most established nationwide medical registry in Germany is the Perinatal Registry, which collects maternal health records concerning pregnancy, delivery and perinatal outcome from now more than 1100 hospitals. Over the past 16 years, data collection was transformed from printed questionnaires to digital records. A special web-based information source of the German Perinatal Registry does not exist. Therefore the Internet platform of the German Working Group for Information Technologies in Gynecology and Obstetrics (AIG) offers a related panel to support technical development and release of the actual dataset-description. In general the objectives of AIG are the introduction and development of digital tools for quality assessment in Obstetrics. | Fertility Sparing Treatments in Young Patients with Gynecological Cancers MINI-REVIEW Fertility Sparing Treatments in Young Patients with Gynecological Cancers Iranian Experience and Literature Review Mojgan Karimi Zarchi1 Azamsadat Mousavi2 Mitra Modares Gilani2 Esmat Barooti2 Omid Amini Rad1 Fatemeh Ghaemmaghami2 Soraya Teimoori3 Nadereh Behtas2 Abstract With increase in the marriage age some women experience gynecological cancers before giving birth. Thus fertility sparing in these patients is an important point and much work has been done on conservative management. We here report our experience on fertility sparing with cervical endometrial and ovarian cancers and include a review of the literature. With cervical cancer radical trachelectomy with para-aortic and pelvic lymphadenectomy can be performed in patients with early stage IA1-IB cancers because they have low recurrence rates. The complications are fewer than with radical hysterectomy. For endometrial cancer the accepted treatment is total abdominal hysterectomy bilateral salpango-oopherectomy TAH BSO but in young patients with early stage 1 lesions we can suggest use of hormonal therapy in place of radical surgery if we evaluate with MRI and the result is early stage disease without the other site involvement and the grade of tumor is well differentiated. GNRH analog oral medroxyprogestrone acetate MPA 100-800 mg day megestrol acetate 40-160 mg day and combination of tamoxifen and a progestin have been applied but we must remember they should underwent repeated curettage for investigating medical outcome after 3 months. With normal pathology we follow medical therapy for 3 months and can evaluate for infertility treatment. The best option for patients who treated by medical therapy is TAH BSO after normal term pregnancy. With ovarian cancer there is much experience on fertility sparing surgery and in Iran conservative surgical management in young patients with stage I grade 1 2 of epithelial ovarian .