Abstract
Introduction
Young patients with cancer face unique challenges, including disruption of family
planning and fertility. Young adults represent an increasing proportion of gastrointestinal
cancer patients, and the prevalence of pretreatment fertility preservation counseling
in this population is unknown.
Methods
Women 18–40 years who underwent surgery for gastric, colorectal, hepatobiliary, or
pancreatic cancer from 2004 to 2019 were identified through the Mayo Clinic Cancer
Registry. Natural language processing was used to search electronic medical records
and identify documentation of pretreatment fertility counseling.
Results
In total, 216 reproductive-age women who underwent resection of gastrointestinal cancers
were identified. Pretreatment fertility preservation counseling by any provider was
documented in 29 (13%) of the entire cohort. This increased to 26 (23%) in women who
also received systemic therapy. This rate did not change over time (p > 0.05). Women
who had pretreatment fertility preservation counseling were younger, had higher stage
disease, and were more likely to undergo chemotherapy (all p < 0.05). Of the 29 women
who had a documented pretreatment discussion, 22 (76%) met with a fertility specialist
and 14 (48%) eventually underwent a fertility preservation procedure.
Conclusion
A small subset of reproductive-age women who underwent surgery for gastrointestinal
cancer had documented pretreatment fertility preservation counseling and only one
in ten women met with a fertility specialist. The high rate of proceeding to fertility
preservation treatment further supports the importance of this discussion in all patients
and represents an opportunity for improvement.
Keywords
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Article info
Publication history
Published online: January 31, 2023
Accepted:
January 31,
2023
Received in revised form:
January 18,
2023
Received:
October 19,
2022
Identification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
