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Michalczyk K, Cymbaluk-Płoska A. Approaches to the Diagnosis and Management of Ovarian Cancer in Pregnancy. Cancer Manag Res 2021; 13:2329-2339. [PMID: 33732025 PMCID: PMC7959196 DOI: 10.2147/cmar.s290592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/10/2021] [Indexed: 12/28/2022] Open
Abstract
Ovarian cancer is one of the most common gynecological cancers diagnosed in pregnancy. Its management is often very problematic due to the proximity of the adnexa to the developing fetus and chemotherapy-related toxicity risk. Tumor markers and imagining studies play important roles in diagnosis, help differentiate benign masses from malignancy and allow to plan the treatment. Due to the physiological changes that occur in pregnancy, levels of tumor markers can be altered and reduce their diagnostic value. We review current recommendations for the management and treatment of ovarian cancer in pregnant patients considering gestational age at diagnosis, tumor histology, stage of the disease, risk of obstetrical complications, and patient’s preferences.
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Affiliation(s)
- Kaja Michalczyk
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Fayek IS, Amira G, Habashy NF, Attia MAAE. A Retrospective Study of Ovarian Sex Cord Stromal Tumors at the Egyptian National Cancer Institute. JOURNAL OF CANCER THERAPY 2019; 10:920-937. [DOI: 10.4236/jct.2019.1012079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Ghalleb M, Bouzaiene H, Sghaier S, Bouaziz H, Hechiche M, Hassouna JB, Rahal K. Fertility sparing surgery for ovarian sex cord stromal tumors: a nine case series. Pan Afr Med J 2018; 31:221. [PMID: 31447979 PMCID: PMC6691291 DOI: 10.11604/pamj.2018.31.221.15531] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/01/2018] [Indexed: 12/23/2022] Open
Abstract
Ovarian Sex Cord Stromal Tumors (SCST) are a rare disease carrying a good prognosis. They generally affect young women; therefore fertility preservation is a critical issue. Fertility Sparing Surgery (FSS) showed promising results in both oncologic safety and fertility preservation. A retrospective case series involving 9 patients diagnosed with SCST and treated with fertility sparing surgery at our institution was conducted between January 2000 and May 2015. The median age was 24 years old (10 to 39). The main clinical manifestation was pelvic pain seen in seven patients. Five patients complained about menstrual cycle disorders. The nine patients went through fertility sparing surgery; seven had conservative staging and the other two had a unilateral salpingo-oophorectomy. Three patients out of nine had a pelvic unilateral lymphadenectomy. Two patients received adjuvant chemotherapy. Only two patients presented locoregional recurrence that occurred respectively after 7 and 192 months. The treatment combined chemotherapy and surgery based on mass resection. One patient achieved a natural pregnancy after the treatment. FSS seems to be a suitable approach for SCST. However, more case series and meta-analysis should be conducted.
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Affiliation(s)
- Montassar Ghalleb
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
| | - Hatem Bouzaiene
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
| | - Sarah Sghaier
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
| | - Hanen Bouaziz
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
| | - Monia Hechiche
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
| | - Jamel Ben Hassouna
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
| | - Khaled Rahal
- Surgical Oncology Department, Institut Salah Azaiez de Cancérologie, Tunis, Tunisie.,Faculté de Médicine Tunis El Manar, Tunis, Tunisia
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Thomakos N, Malakasis A, Machairiotis N, Zarogoulidis P, Rodolakis A. Fertility Sparing Management in Non-Epithelial Ovarian Cancer. Which Patients, What Procedure and What Outcome? J Cancer 2018; 9:4659-4664. [PMID: 30588250 PMCID: PMC6299391 DOI: 10.7150/jca.26674] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 09/15/2018] [Indexed: 12/18/2022] Open
Abstract
Non epithelial ovarian tumors represent a small group of rare gynecological cancers but they have a high incidence in young childbearing women. The recent years fertility preservation surgeries have become a common practice in specific ovarian malignancies when the patients wish to maintain their fertility. Specific types of non-epithelial ovarian tumors can be managed with fertility sparing operations with a similar outcome to more radical intervention but due to the rarity of these tumors the extent of the operation remains in some cases controversial. Moreover, the reproductive outcome of the women that had these conservative operations seems to be very promising. In our review we try to summarize the data regarding the fertility sparing management of all types of non-epithelial ovarian cancers and what procedure should be performed in each case. Finally we have accumulated the data concerning the reproductive outcome of patients that had undergone this type of surgery.
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Affiliation(s)
- Nikolaos Thomakos
- First Department of Obstetrics and Gynecology, Alexandra Hospital, Gynecologic Oncology Unit, University of Athens, Athens, Greece
| | - Anastasios Malakasis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, Gynecologic Oncology Unit, University of Athens, Athens, Greece
| | - Nikolaos Machairiotis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, Gynecologic Oncology Unit, University of Athens, Athens, Greece
| | - Paul Zarogoulidis
- 3rd Department of Surgery, "AHEPA" University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Alexandros Rodolakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, Gynecologic Oncology Unit, University of Athens, Athens, Greece
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