A comprehensive review of childbearing after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Papageorgiou, Dimitrios; Manatakis, Dimitrios K.; Papakonstantinou, Katerina; Kyriazanos, Ioannis

doi:10.1007/s00404-020-05687-z

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…A total hysterectomy with bilateral salpingo-oophorectomy may be recommended, regardless of pre-operative gynecologic organ involvement. However, young women may wish to avoid the associated iatrogenic surgical menopause and permanent infertility ( 11 ), which can have major psychosocial consequences and a negative impact on the quality of life of the patient and her family. In the present study, there was a significant difference in age between patients who chose to preserve their ovaries during CRS and those who underwent ovarian resection, with younger patients more likely to choose ovarian preservation.…”

Section: Discussionmentioning

confidence: 99%

Prognosis for Young Females with Pseudomyxoma Peritonei of Appendiceal Origin and Unilateral or Bilateral Ovaries Preserved During Cytoreductive Surgery

Tang²,

Lu³

et al. 2022

Front. Surg.

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ObjectiveTo determine prognosis for young female patients with peritoneal pseudomyxoma (PMP) of appendiceal origin and unilateral or bilateral ovaries preserved during cytoreductive surgery (CRS).MethodsClinical data of female patients treated with CRS with or without hyperthermic intraperitoneal chemotherapy (HIPEC) at the Aerospace Center Hospital, Beijing between January, 2009 and December, 2019 were retrospectively reviewed. Patients had no changes in the bilateral ovaries on gross pathological observations or biopsy during CRS, and normal ovarian function. The demographic and clinical characteristics and prognosis of women with ovaries preserved (ovarian preservation group) or resected (ovarian resection group) during CRS were compared. Independent prognostic factors for survival were identified using univariate and multivariate analysis.Results40 patients were included in the final analysis. 19 patients chose ovarian preservation while 21 patients underwent ovarian resection. Completeness of cytoreduction (CCR) scores were CCR-0/1. There were significant differences in age (<40 vs. ≥40), symptoms, intraoperative HIPEC (Y vs. N), and histopathologic subtype of PMP (low-grade vs. high-grade) (p < 0.001) between patients in the ovarian preservation and ovarian resection groups. In the ovarian preservation group, median overall survival (OS) was 59 months (range, 53–65 months), and the 5-year survival rate was 37.9%. Median disease-free survival (DFS) was 13 months (range, 9–17 months), and the 5-year recurrence rate was 87.4%. In the ovarian resection group, the 5-year survival rate was 87.7%, and the 5-year recurrence rate was 18.3%. Median OS and median DFS were not reached. In patients with low-grade PMP, median DFS was significantly longer in patients with ovarian resection compared to ovarian preservation (p < 0.001). Univariate analysis showed histopathologic subtype of PMP (low-grade vs. high-grade, p < 0.001) was significantly associated with OS and DFS. On multivariate analysis, high-grade histopathologic subtype of PMP was an independent predictor of poor prognosis (OS and DFS).ConclusionHistopathologic subtype of PMP represents an independent predictor of prognosis in female patients with PMP of appendiceal origin and unilateral or bilateral ovaries preserved during CRS. These findings imply that ovarian preservation is a more suitable option for young females with low-grade PMP compared to high-grade PMP. Further prospective studies should be done investigating the role of resection of uninvolved ovaries in PMP.

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Section: Discussionmentioning

confidence: 99%

Prognosis for Young Females with Pseudomyxoma Peritonei of Appendiceal Origin and Unilateral or Bilateral Ovaries Preserved During Cytoreductive Surgery

Tang²,

Lu³

et al. 2022

Front. Surg.

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“…Regarding the safety of these two treatments (HIPEC + CRS), studies were conducted to show their utility, even in pregnancy, as explained by Papageorgiou [76], who concluded that pregnancy could be achieved in certain individuals after CRS and HIPEC. He also emphasized the importance of discussing assisted reproduction methods with the patient before the operation, ensuring that it does not impact overall survival or increase the chance of locoregional recurrence.…”

Section: Treatmentmentioning

confidence: 99%

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Ionescu,

Marincas,

Madge

et al. 2024

Cancers

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Background. Pseudomyxoma peritonei (PMP) is a rare, progressive, slowly growing, inadequately understood neoplasm with a 5-year progression-free survival rate of as low as 48%. It is characterized by varying degrees of malignancy and the production of mucinous and gelatinous structures. Typically, the development of pseudomyxoma peritonei is associated with the rupture of appendiceal mucinous tumors and other gastrointestinal or ovarian mucinous tumors. The goal of our literature review was to identify various aspects that characterize the ovarian causes of pseudomyxoma peritonei. Materials and methods. The authors performed an extensive literature search between 1 February 2024 and 2 March 2024 on the following databases: Pubmed, Scopus, Oxford Journals, and Reaxys, and the findings were summarized into seven main clinical and paraclinical situations. Results. According to our research, the main instances in which pseudomyxoma peritonei can be triggered by an ovarian cause are the following: (1) mucinous cystadenoma; (2) mucinous ovarian cancer; (3) colon cancer with ovarian metastasis; (4) malignant transformation of an ovarian primary mature cystic teratoma; (5) appendiceal mucocele with peritoneal dissemination mimicking an ovarian tumor with peritoneal carcinomatosis; (6) mucinous borderline tumor developing inside an ovarian teratoma; and (7) the association between a mucinous bilateral ovarian cancer and a colonic tumor. Conclusions. In our study, we aimed to provide a comprehensive overview of the ovarian causes of pseudomyxoma peritonei, including its epidemiology, imagery characteristics, symptoms, current treatment, and promising future therapies, in the hopes of finding feasible solutions, as a lack of understanding of this mucus-secreting malignant disease increases the risk of delayed diagnosis or uncontrolled deterioration.

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Gendermedizin bei peritonealen Erkrankungen

Köhler,

Rau

2024

Chirurgie

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A comprehensive review of childbearing after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Cited by 5 publications

References 29 publications

Prognosis for Young Females with Pseudomyxoma Peritonei of Appendiceal Origin and Unilateral or Bilateral Ovaries Preserved During Cytoreductive Surgery

Prognosis for Young Females with Pseudomyxoma Peritonei of Appendiceal Origin and Unilateral or Bilateral Ovaries Preserved During Cytoreductive Surgery

Ovarian Causes of Pseudomyxoma Peritonei (PMP)—A Literature Review

Gendermedizin bei peritonealen Erkrankungen

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