Current status of oncofertility care for the AYA cancer patients with ovarian germ cell tumors in Japan - a fact-finding survey by Japan agency for medical research and development (AMED)

u3010Introductionu3011The major fact-finding survey on oncofertility care has not been conducted to date in the field of gynecologic oncology. Therefore, we examined AYA (adolescent and adult) cancer patients with ovarian germ-cell tumors (OGT) on fertility preserving therapy and from oncofertility liaisons to elucidate the situation in Japan by AMED survey. u3010Methodsu3011 AYA (age 15–39 years) cancer patients with OGT who received fertility-preserving therapy at the JSOG (Japan Society of Obstetrics and Gynecology) specialist training facilities nationwide from January 2009 to December 2013 (430 cases) were surveyed with respect to surgery applications, surgical styles, outcomes of pregnancy.u3010Resultsu3011No postoperative recurrence was observed in approximately 90% of 415 cases. The ovarian residual function rate was low at 12.8%. Approximately 80% of the cases were stage I cancer. Of the 415 patients, 82.9% underwent adnexectomy during surgery and 13.5% underwent cyst extraction. Abdominal operation and laparoscopy were performed in approximately half of the patients who underwent cyst extraction. Of the 415 patients who underwent surgery, 97 (23.4%) became pregnant. In the pregnancy cases, the rate of referral to the REI (reproductive endocrinology and infertility) specialists in the overall and chemotherapy groups remained at approximately 15%. Meanwhile, the reference rate to the REI specialists was low in the non-pregnant cases (0.8%).u3010Conclusionu3011AYA patients with OGT in Japan undergo therapies described in JSGO (Japan Society of Gynecologic Oncology) clinical guidelines. However, their pregnancy rate is low, and referral to the reproductive is not sufficiently used. Even though the AYA patients with OGT has normal menstruation, the ovarian reserve should be followed by the specialists. Therefore, referring to the REI specialists early on may improve survivorship for this kind of patients.