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Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review

Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. T...

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Autores principales: Gałczyński, Krzysztof, Olcha, Piotr, Romanek-Piva, Katarzyna, Jóźwik, Maciej, Semczuk, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958602/
https://www.ncbi.nlm.nih.gov/pubmed/33801452
http://dx.doi.org/10.3390/jcm10051020
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author Gałczyński, Krzysztof
Olcha, Piotr
Romanek-Piva, Katarzyna
Jóźwik, Maciej
Semczuk, Andrzej
author_facet Gałczyński, Krzysztof
Olcha, Piotr
Romanek-Piva, Katarzyna
Jóźwik, Maciej
Semczuk, Andrzej
author_sort Gałczyński, Krzysztof
collection PubMed
description Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. The diagnosis of this malignancy can have devastating consequences for future fertility because standard treatment protocols for EC include hysterectomy. Here, we present the first detailed review of the world literature on EC in subjects aged 21 years or younger (n = 19). The mean age at diagnosis was 16.7 ± 0.6 years. One patient (5.3%) had a Type II (high-risk) disease. No communication retrieved from the search reported on patient death; however, two (10.5%) patients were lost to follow-up. There was also a high proportion (five subjects, or 26.3%) of cases with genetic background (Cowden syndrome and Turner syndrome), therefore genetic screening or a direct genetic study should be considered in very young patients with EC. The current fertility-sparing options, limited to Type I (low-risk) disease, are presented and discussed. Such information, obtained from studies on older women, translates well to adolescent girls and very young women. Careful anatomopathological monitoring at follow-up is essential for the safety of a conservative approach. Improved survival in very young EC patients makes the preservation of fertility a central survivorship issue, therefore both patients and caregivers should undergo counseling regarding available options. Moreover, our study suggests that genetic syndromes other than Lynch syndrome may be associated with EC more frequently than previously thought.
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spelling pubmed-79586022021-03-16 Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review Gałczyński, Krzysztof Olcha, Piotr Romanek-Piva, Katarzyna Jóźwik, Maciej Semczuk, Andrzej J Clin Med Review Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. The diagnosis of this malignancy can have devastating consequences for future fertility because standard treatment protocols for EC include hysterectomy. Here, we present the first detailed review of the world literature on EC in subjects aged 21 years or younger (n = 19). The mean age at diagnosis was 16.7 ± 0.6 years. One patient (5.3%) had a Type II (high-risk) disease. No communication retrieved from the search reported on patient death; however, two (10.5%) patients were lost to follow-up. There was also a high proportion (five subjects, or 26.3%) of cases with genetic background (Cowden syndrome and Turner syndrome), therefore genetic screening or a direct genetic study should be considered in very young patients with EC. The current fertility-sparing options, limited to Type I (low-risk) disease, are presented and discussed. Such information, obtained from studies on older women, translates well to adolescent girls and very young women. Careful anatomopathological monitoring at follow-up is essential for the safety of a conservative approach. Improved survival in very young EC patients makes the preservation of fertility a central survivorship issue, therefore both patients and caregivers should undergo counseling regarding available options. Moreover, our study suggests that genetic syndromes other than Lynch syndrome may be associated with EC more frequently than previously thought. MDPI 2021-03-02 /pmc/articles/PMC7958602/ /pubmed/33801452 http://dx.doi.org/10.3390/jcm10051020 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Gałczyński, Krzysztof
Olcha, Piotr
Romanek-Piva, Katarzyna
Jóźwik, Maciej
Semczuk, Andrzej
Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review
title Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review
title_full Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review
title_fullStr Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review
title_full_unstemmed Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review
title_short Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review
title_sort fertility-sparing methods in adolescents affected by endometrial cancer: a comprehensive review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958602/
https://www.ncbi.nlm.nih.gov/pubmed/33801452
http://dx.doi.org/10.3390/jcm10051020
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