Prevalence of deaths in a cohort of girls and women with cryopreserved ovarian tissue

Abstract

Introduction: Ovarian tissue cryopreservation (OTC) is increasingly offered to women in need of fertility preservation. However, little is known about the risk of these women dying before they use the preserved material.

Material and methods: From 1999 to 2016, 927 girls and women underwent OTC in our center, before receiving gonadotoxic treatment. All patients were without disseminated disease and with an estimated chance of survival after 5 years of >50%. For each patient the specific indication for OTC was noted, and through a national registry linked to a personal identification number, we were able to identify those who had died and the date and cause of death.

Results: By December 2017, 124/927 patients had died from their disease (13%). The highest relative prevalence of death was seen in patients with liver cancer (2/2; 100%), gall bladder cancer (2/2; 100%), stomach cancer (1/1; 100%), hemophagocytic lymphohistiocytosis (2/3; 66%), scleroderma (1/2; 50%), and sarcoma (24/78; 31%). The lowest risk of dying was seen in the group of individuals with non-Hodgkin lymphoma (3/30; 10%) and breast cancer (31/313; 10%). The shortest time from OTC to death was seen in those with hemophagocytic lymphohistiocytosis (mean interval 0.25 years), gall bladder cancer, non-Hodgkin disease and acute myeloid leukemia (mean interval 0.7 years) and the longest time from OTC to death was in women with breast cancer (mean interval 3.4 years). Of those who died, 34 had received chemotherapy at some point before OTC, indicating a relapse or non-responsiveness to the initial treatment.

Conclusions: Patients with upper gastrointestinal cancers and sarcoma had the highest risk of dying from their disease. Breast cancer patients had the lowest risk. This knowledge may guide clinicians in their decisions on whether to offer OTC to girls and younger women with a life-threatening disease.

Keywords: Cancer; cryopreservation; fertility preservation; ovarian tissue; ovary; survival rate.