Fertility preservation treatment of gynecological cancer patients in Spain: a national survey (GOFER study)
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GYNECOLOGIC ONCOLOGY
Fertility preservation treatment of gynecological cancer patients in Spain: a national survey (GOFER study) Mikel Gorostidi1 · Blanca Gil‑Ibañez2 · Sonsoles Alonso3 · Antonio Gil‑Moreno4,5 · Alicia Hernandez6 · Aureli Torné2 · Ignacio Zapardiel6 Received: 11 December 2019 / Accepted: 13 February 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To analyze the current management and use of fertility preservation (FP) treatments among different gynecologic oncology centers in Spain Methods From March to April 2019, a transversal study was conducted using a national online survey to consultants registered in the section of Gynecologic Oncology of the Spanish Society of Obstetrics and Gynecology. The survey contained 30 questions that assessed the perceptions and attitudes towards fertility-sparing strategies as well as its management in each participating center. Results A total of 51 responders from 12 out of 17 geographical regions of Spain answered the survey. According to 35 responders (68.63%), the age limit for offering FP was 40 years. In most of the centers, an ovarian reserve study is carried out prior to a FP procedure (34 responders, 66.67%). In cervical cancer size, limit for offering trachelectomy is 2 cm (40 responders, 78.43%), with LVSI as an exclusion factor for 26 (51%). Twenty-four (48.98%) responders reported that FP only in ovarian cancer stages IA, 12 (24.49%) also in stages IB, and an additional 13 (26.53%) up to stages IC. Most responders perform FP only in the absence of myometrial infiltration (30, 58.82%) in patients with g1–g2 endometrial cancer. Conclusions The performance of professionals at the national level is uneven, demonstrating the need for referral centers to ensure optimal management. International guidelines should be more widely extended throughout Spain to homogenize the treatment of young oncology patients who wish to have children. Keywords Gynecological cancer · Fertility preservation treatments · Early cervical cancer · Conservative treatment endometrial cancer
Introduction * Blanca Gil‑Ibañez [email protected] 1
Gynecologic Oncology Unit, Donostia University Hospital, San Sebastián, Spain
2
Gynecologic Oncology Unit, Hospital Clinic, Barcelona, Spain
3
Gynecologic Oncology Unit, MD Anderson Cancer Center International, Madrid, Spain
4
Gynecologic Oncology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
5
Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Madrid, Spain
6
Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
Over the last decades, there has been a rising trend of delaying childbearing in developed countries. The diagnosis of gynecological cancer before having completed gestational desire has, therefore, become an increasing problem in clinical practice. As early detection and improvements in cancer treatment contribute to long-term survival, fertility preservation (FP) has become one of the maj
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