Author | Yukio Sonoda, MD

Articles

Fertility Preservation in Patients With Cervical Cancer

July 15, 2015

Fertility preservation for patients diagnosed with early-stage cervical cancer is feasible and has gained acceptance within the gynecologic oncology community.

Reproductive Issues in the Gynecologic Cancer Patient

April 30, 2007

For women with a gynecologic cancer, reproductive concerns may vary not only by site of disease but also by the presentation and manifestation of the disease. Gynecologic cancer can present before childbearing has been started or completed, during pregnancy, or can even arise out of pregnancy.

Commentary (Sonoda): Fertility-Preserving Options for Cervical Cancer

April 17, 2006

Childbearing is one of the most important life goals for many women, and fertility preservation is a very important factor in the overall quality of life of cancer survivors. Cervical cancer frequently affects young women; because some women tend to delay childbearing, fertility preservation must be considered when treatment options are discussed. Over the past decade, the radical trachelectomy procedure has become a well established fertility-preserving option for young women with early-stage cancer; this procedure is associated with low morbidity, good oncologic outcome, and a high proportion of pregnancies that reach the third trimester and babies that are delivered at term. This article will review available literature on the vaginal radical trachelectomy procedure and data from other surgical approaches, such as the abdominal radical trachelectomy. In addition, the potential future application of neoadjuvant chemotherapy followed by fertility-preserving surgery in patients with locally advanced cervical cancer will be examined. Finally, ultraconservative surgical approaches (eg, conization alone with or without laparoscopic lymphadenectomy) in very early-stage disease will be discussed.

Management of Early Ovarian Cancer

March 01, 2004

Epithelial ovarian cancer is the leading cause of death from gynecologicmalignancies in the United States due, in large part, to the advancedstage at which it is commonly diagnosed. However, approximatelyone-third of cases are discovered at an early stage, when tumoris limited to the pelvis. Certain prognostic factors have been identified,which place patients with early disease at risk for recurrence and warrantthe use of adjuvant therapy. Systemic chemotherapy remains themost commonly used adjuvant therapy in this setting, and several randomizedEuropean trials have recently suggested a benefit to its use.These studies, however, suffered from the lack of comprehensive staging,which must be considered when interpreting the literature on earlystagedisease. Ideally, these patients should have access to a gynecologiconcologist prior to their initial surgical procedure.