Premium
Fertility after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A call to action
Author(s) -
Violette Caroline,
Kim Tesia,
Shandley Lisa,
Lee Rachel,
Staley Charles,
Winer Joshua,
Maithel Shishir,
Hipp Heather,
Kawwass Jennifer,
Russell Maria
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26387
Subject(s) - medicine , hyperthermic intraperitoneal chemotherapy , fertility preservation , fertility , hysterectomy , cytoreductive surgery , oocyte cryopreservation , abdominal hysterectomy , surgery , general surgery , gynecology , cancer , ovarian cancer , population , environmental health
Abstract Introduction Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly accepted as the best therapeutic option in primary and some secondary peritoneal malignancies. The ramifications of this procedure on fertility are unknown. The aim of this study was to assess the current association of CRS/HIPEC with fertility following surgery. Methods A review of patients who underwent CRS/HIPEC between 2009 and 2018 was performed. Female patients were included if they were between ages 18–50 at the time of surgery. Gynecologic and obstetric history before and following CRS/HIPEC was collected by phone interview. Results Of 48 eligible participants, 21 completed the survey. Sixty‐five percent of women underwent a total abdominal hysterectomy before or during CRS. Twenty‐nine percent of these women recall fertility counseling before CRS/HIPEC, while 14.3% saw a fertility specialist for consultation, and only one patient proceeded with oocyte cryopreservation before treatment. There were no pregnancies reported following treatment with CRS/HIPEC. Conclusion Few patients after CRS/HIPEC retain child‐bearing potential, partly due to the high rate of hysterectomy and oophorectomy at time of surgery. Efforts towards improved preoperative counseling, increased oocyte cryopreservation, and evaluating the safety of preserving reproductive organs at the time of surgery are needed.