fertility-sparing treatments

  • 文章类型: Journal Article
    本文的主要目的是评估和分析目前在保留生育力的宫颈癌治疗研究中引用最多的100篇文章。
    在WebofScienceCoreCollection数据库中搜索有关宫颈癌保留生育治疗的前100篇被引用最多的文章,对文章的不同方面进行了分析,包括国家,期刊,机构,作者,关键词和主题。
    搜索一直进行到2023年8月,前100篇文章的引用次数从19到212不等。这些文章来自28个不同的国家,和普兰特教授一起,来自加拿大的M.和Sonoda教授,Y.来自美国的文章数量最多,两者都是10普兰特教授,M.是9篇文章的第一作者和9篇文章的通讯作者。美国纪念斯隆·凯特琳癌症中心发表的文章最多(21),共收到258次引用。妇科肿瘤学发表了前100篇文章中的37篇,共引用524次,平均每篇文章引用14.16次。
    该研究得出的结论是,根据文章数量,美国在这一领域做出了最重要的贡献,作者,和机构。此外,关键词聚类和突发性分析揭示了该领域的研究热点和未来趋势。
    UNASSIGNED: The primary objective of this paper was to assess and analyze the top 100 most cited articles currently cited in studies of fertility-sparing treatments for cervical cancer.
    UNASSIGNED: Searching the Web of Science Core Collection database for the top 100 most cited articles on fertility-sparing treatments for cervical cancer, different aspects of the articles were analyzed, including countries, journals, institutions, authors, keywords and topics.
    UNASSIGNED: The search was conducted up to August 2023, and the number of citations for the top 100 articles ranged from 19 to 212. These articles originated from 28 different countries, with Professor Plante, M. from Canada and Professor Sonoda, Y. from the USA having the highest number of articles, both with 10. Professor Plante, M. was the first author of 9 articles and corresponding author of 9 articles. The Memorial Sloan Kettering Cancer Center in the USA published the most articles (21) and received a total of 258 citations. Gynecologic Oncology published 37 of the top 100 articles, with 524 citations and an average of 14.16 citations per article.
    UNASSIGNED: The study concludes that the USA has made the most significant contributions to this field based on the number of articles, authors, and institutions. Additionally, keyword clustering and burst analysis revealed the research hotspots and future trends in this area.
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  • 文章类型: Case Reports
    对于希望保留其生殖潜力的非典型子宫内膜增生(AEH)或子宫内膜癌(EC)的年轻女性,保留生育力的治疗已变得重要。证据表明,体重与EC之间存在很强的关系,以及体重减轻对降低EC风险的影响。我们报告了一个年轻的肥胖女性,其体重指数(BMI)为46.6kg/m2,诊断为2级子宫内膜样腺癌,接受宫腔镜切除联合保留生育力治疗,然后插入左炔诺孕酮宫内节育系统。在十二个月未能获得完整的回应之后,减重手术是为了减轻体重和改善对治疗的反应。手术后三个月实现组织学消退,联合治疗子宫内膜癌15个月后体重减轻30公斤。我们回顾了文献,以总结有关减肥手术和体重减轻在改善非典型子宫内膜病变的保留生育治疗妇女的肿瘤和生殖结局方面的作用的证据。
    Fertility-sparing treatments have become important for young women with atypical endometrial hyperplasia (AEH) or endometrial carcinoma (EC) who wish to preserve their reproductive potential. Evidence indicates a strong relationship between weight and EC and the effect of weight loss on reducing the risk of EC. We report the case of a young obese woman with a body mass index (BMI) of 46.6 kg/m2, diagnosed with grade 2 endometrial endometrioid adenocarcinoma, who underwent a combined fertility-sparing treatment with hysteroscopic resection followed by insertion of a levonorgestrel intrauterine system. After twelve months of failure to achieve a complete response, bariatric surgery was proposed to lose weight and improve the response to treatment. Histologic regression was achieved three months after surgery, with a weight loss of 30 kg and fifteen months after combined treatment of endometrial cancer. We reviewed the literature to summarize the evidence on the role of bariatric surgery and weight loss in modifying the oncologic and reproductive outcomes of women undergoing fertility-sparing treatment for atypical endometrial lesions.
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  • 文章类型: Journal Article
    UNASSIGNED: To investigate the oncologic and reproductive outcomes of fertility-sparing treatments (FSTs) in atypical endometrial hyperplasia (AEH) and endometrial cancer (EC) patients with excess weight (EW).
    UNASSIGNED: This retrospective study comprised patients with AEH or EC who achieved a complete response (CR) after FST from 2010 to 2018. The clinical characteristics, oncological and reproductive outcomes were compared between the excess weight (EW) group (body mass index (BMI)≥25 kg/m2) and normal weight (NW) group (BMI<25 kg/m2). The risk factors associated with recurrence and unsuccessful pregnancy in patients with EW were analyzed.
    UNASSIGNED: Overall, 227 patients were enrolled, including 139 (61.2%) in EW group and 88 (38.8%) in NW group. In patients with EW, the pregnancy rate, the live birth rate and the relapse rate were 29.8%, 23.4%, and 30.9%, respectively. In patients with NW, these rates were 61.1%, 47.2%, and 31.8%, respectively. No significant differences were observed in the time to remission (P=0.865) and disease-free survival (DFS) (P=0.750). Patients in NW group achieved a better pregnancy rate than patients in the EW group (P=0.034). The patients with EW using ovulation induction to increase fertility tended to have a shorter time to pregnancy (P=0.042). However, no significant risk factors associated with unsuccessful pregnancy were identified after the multivariate analysis. In terms of DFS, the combination of gonadotropin-releasing hormone agonist (GnRH-a) and LNG-IUD was better for patients with EW than GnRH-a or oral progestin therapy alone (P=0.044, adjusted hazard ratio (HR)=0.432, 95% confidence interval (CI): 0.152-1.229), especially for patients with EW diagnosed with EC (P=0.032).
    UNASSIGNED: FSTs for overweight and obese patients should be more individualized. GnRH-a and/or LNG-IUD may be options prior to FSTs in patients with EW. Further prospective studies are needed.
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