Fertility following treatment of high-grade malignant bone and soft tissue tumors in young adults

Abstract

Abstract. This study was conducted to investigate marriage and fertility in long-term survivors with high-grade bone and soft tissue tumors following chemotherapy. We reviewed issues related to fertility in 47 patients (24 men and 23 women) who had survived for >5 years. The median age at diagnosis was 18.0±8.9 years and the mean duration of follow-up 11.0 years. We investigated the proportions of married subjects (number of married/total number of subjects) and fertile subjects (number who had fathered or conceived offspring/total number of subjects), the interval between first delivery and last chemotherapy, type of delivery, congenital deformities in the offspring and the association between cumulative dose of chemotherapeutic agents and subsequent reproduction. The final proportions of married and fertile subjects following sarcoma treatment were 36.2% (17/47) and 29.8% (14/47), respectively. Two subjects had fathered and 8 had conceived a total of 15 offspring. The proportion of fertile men was significantly lower compared to that of women. The mean interval between the last chemotherapy and the first delivery was 9.5 years. Of the 10 first births, 6 were normal transvaginal deliveries and 4 were caesarean sections (1 was a medical termination due to lung metastases, 1 was due to infected amniotic fluid caused by uterine myomas and 2 were performed due to abnormal rotation of the fetus). No offspring presented with congenital deformities. Fertile men had received smaller cumulative chemotherapeutic agent doses, particularly of ifosfamide, compared to those who had not fathered any offspring. In conclusion, infertility occurs more frequently in men compared to women following intensive chemotherapy. All the patients should be offered counseling regarding the potential risk of infertility prior to cancer treatment.

Fertility in female cancer survivors: a systematic review and meta-analysis

“…After review of the titles and abstracts, 41 studies were identified as potentially eligible for inclusion. After full review, four systematic reviews were excluded (Levine et al, 2015;Lopategui et al, 2017;van Dorp et al, 2016;Burkart et al, 2019), one publication because data could not be extracted (Zynda et al, 2012), 15 original studies because of the absence of a healthy control group (Carter et al, 2006;Kiserud et al, 2007;Sudour et al, 2010;Speiser et al, 2011;Hamre et al, 2012;Hansen et al, 2013;Reinmuth et al, 2013;Shepherd et al, 2006;Greaves et al, 2014;Naessén et al, 2014;Hoshi et al, 2015;Wu et al, 2015;Yonemoto et al, 2016;Shandley et al, 2017;Nichols et al, 2018) and three additional studies because they generically referred to reproductive prognosis after cancer without splitting data for cancer subtypes (Green et al, 2009;Reulen et al, 2009;Dillon et al, 2013).…”

“…In fact, amputation is routinely carried out on patients with high-grade bone and soft tissue tumours in the extremities. Limbpreserving surgery with a wide margin achieves positive outcomes in selected cases; however, loss of limb function remains an unsolved problem (Hoshi et al, 2015). The psychological sequelae of such aggressive therapies inevitably affect the relationship life.…”

Recurrent Metastatic High-Grade Osteosarcoma: Disease Stabilization and Successful Pregnancy Outcome following Aggressive Multimodality Treatment

“…Exposure to chemotherapy not only increases the risk of miscarriages and early menopause but also potentially increases the risk of congenital deformities for the child. [15][16][17][18] Our patient delivered a healthy boy without any deformity.…”

The impact of COVID-19 pandemic on bone and soft tissue tumor treatment: a single institution study

“…In addition, perioperative complications (soft tissue necrosis, pneumothorax, sepsis, wound infection, and fracture) were recorded and defined as grade ≥3 based on the Common Terminology Criteria for Adverse Events (CTCAE v5.0; National Cancer Institute). For the anticancer treatment of malignant bone and soft tissue 8 tumors, we used a method similar to that reported by Hoshi et al [15].…”