We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Edited by
Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York,Nisha Lakhi, Richmond University Medical Center, Staten Island,Nicoletta Colombo, University of Milan-Bicocca
Concomitant chemo-radiation followed by brachytherapy, for the treatment of locally advanced cancer, is considered as the standard of care in many countries. The place of “adjuvant” hysterectomy to remove potential residual disease after the end of radiation therapy fuels a lot of debates during the three last decades. But using modern technics of external radiation therapy and brachytherapy (3D image-guided adaptive procedure) the rate of patients with residual disease is low (<10%) and the morbidity of hysterectomy in this previously irradiated area consistent. As randomized trial failed to demonstrate a survival improvement of such hysterectomy, many teams considered this procedure as useless and obsolete. Such surgery could be nevertheless considered in patients having “really” a residual disease at the end of treatment but such cases should be highly selected to ensure the absence of extra-cervical disease in these patients having chemo-radio-resistant disease with a higher risk of extra-pelvic occult spread.
Although cancer usually affects aged population, invasive gynecological tumors can occur during reproductive age. Long-term survival rates after gynecological cancer are improving and preservation of fertility has logically become a major issue.
In gynecologic oncologic surgery, there has been gradual development of fertility-saving surgery (FSS) with the aim of preserving the reproductive organs. Survival should not be compromised and thus indications are restricted to patients of a young age with a desire to preserve fertility and presenting with a well-differentiated cervical, ovarian, or endometrial low-grade tumor in its early stages or with low malignant potential.
In this chapter, we discuss indications for FSS in women with gynecological cancer, according to oncological and reproductive outcomes.
Understanding the basics of cryobiology to develop improved cryopreservation procedures has been a major challenge to scientists all over the world. During a typical cryopreservation process ice tends to form at different rates. Intracellular ice formation is generally thought to be lethal as it causes injury to cellular membranes and intracellular structures. Conventional slow freezing protocols involve pretreatment of cells with cryoprotective agents (CPAs) in order to remove some water from the cells and to minimize some other harmful effects of freezing. The rate at which permeable CPA diffuses into the cells varies between the cryoprotectants and is also temperature and concentration dependant. Vitrification has become an increasingly accepted method for preserving embryos, oocytes and, recently, even sperm. An ideal vitrification method produces no ice formation and may therefore be an equilibrium method. The benefits of sperm cryopreservation are numerous in human reproductive medicine.