TY - JOUR
T1 - Safety of laparoscopic oophorectomy in a Dutch national pediatric cancer cohort
AU - Clasen, Nikita H.Z.
AU - van der Perk, M. E.Madeleine
AU - van de Wetering, Marianne D.
AU - Bos, Annelies M.E.
AU - van der Kooi, Anne Lotte L.F.
AU - van Loon, Kim
AU - Veening, Margreet A.
AU - IJgosse, Irene M.
AU - Neggers, Sebastian J.C.M.M.
AU - van Grotel, Martine
AU - Bresters, Dorine
AU - van Santen, Hanneke M.
AU - Verpoest, Willem M.J.A.
AU - Looijenga, Leendert H.J.
AU - Arends, Brigitte
AU - van Leeuwen, Jeanette
AU - Broer, Simone L.
AU - van der Steeg, Alida F.W.
AU - van den Heuvel-Eibrink, Marry M.
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2026/2
Y1 - 2026/2
N2 - Objective: To report our experiences on the safety of laparoscopic oophorectomy (LO) for ovarian tissue cryopreservation in childhood cancer (CC) patients. Design: Descriptive study of a prospectively registered cohort. Subjects: All CC patients undergoing LO in the Netherlands from November 2020 until April 2024. Exposure: Laparoscopic oophorectomy for means of fertility preservation before or during gonadotoxic treatment. Main Outcome Measures: Safety, including procedure-related complications, such as critical events (desaturation, bradycardia), need for mechanical ventilation in a pediatric intensive care unit (PICU), site infections, hemorrhage, and survival, scored according to Clavien Dindo (CD) classification. Results: Eighty-eight patients, median age 6.5 years (range 1–18 years) underwent LO, of which 2/88 patients developed CD grade 4, 1/88 CD grade 3, and 8/88 CD grade 2 complications, with the most common being port site infection (6%) and bleeding (6%). No clear determinant could be identified as a risk factor for complications. All patients recovered from procedure-related complications and no patient died as a consequence of oophorectomy. Conclusion: Laparoscopic oophorectomy is a relatively safe procedure to preserve future fertility for girls with cancer with a high risk of gonadal failure and consequent infertility. However, LO can be accompanied by complications in children with cancer. Therefore, safety monitoring and identification of risk factors for complications based on larger cohorts in future studies are needed. Prevention of complications of LO is an important obligation to balance the future benefits against the risks of LO to enhance the future chance of pregnancy for girls with cancer.
AB - Objective: To report our experiences on the safety of laparoscopic oophorectomy (LO) for ovarian tissue cryopreservation in childhood cancer (CC) patients. Design: Descriptive study of a prospectively registered cohort. Subjects: All CC patients undergoing LO in the Netherlands from November 2020 until April 2024. Exposure: Laparoscopic oophorectomy for means of fertility preservation before or during gonadotoxic treatment. Main Outcome Measures: Safety, including procedure-related complications, such as critical events (desaturation, bradycardia), need for mechanical ventilation in a pediatric intensive care unit (PICU), site infections, hemorrhage, and survival, scored according to Clavien Dindo (CD) classification. Results: Eighty-eight patients, median age 6.5 years (range 1–18 years) underwent LO, of which 2/88 patients developed CD grade 4, 1/88 CD grade 3, and 8/88 CD grade 2 complications, with the most common being port site infection (6%) and bleeding (6%). No clear determinant could be identified as a risk factor for complications. All patients recovered from procedure-related complications and no patient died as a consequence of oophorectomy. Conclusion: Laparoscopic oophorectomy is a relatively safe procedure to preserve future fertility for girls with cancer with a high risk of gonadal failure and consequent infertility. However, LO can be accompanied by complications in children with cancer. Therefore, safety monitoring and identification of risk factors for complications based on larger cohorts in future studies are needed. Prevention of complications of LO is an important obligation to balance the future benefits against the risks of LO to enhance the future chance of pregnancy for girls with cancer.
KW - Childhood cancer
KW - fertility preservation
KW - oophorectomy
KW - safety
UR - https://www.scopus.com/pages/publications/105025458245
U2 - 10.1016/j.xfre.2025.11.008
DO - 10.1016/j.xfre.2025.11.008
M3 - Article
C2 - 41694257
AN - SCOPUS:105025458245
VL - 7
SP - 69
EP - 80
JO - F&S reports
JF - F&S reports
IS - 1
ER -