She is a 12-year-old Roman girl, being treated for a sarcoma, the first minor patient to undergo ovarian tissue removal for cryopreservation at the Agostino Gemelli Irccs University Hospital Foundation in Rome. A procedure that allows you to maintain the hopes of having a child, in the future, after facing cancer. The collection was carried out by virtue of an agreement signed in January 2022 with the Bank of Ovarian Tissue and Germ Cells (BTO) of the Lazio Region, which is based at the hospitaller physiotherapy institutes of Rome (Ifo) and is directed by Enrico Vizza, which is currently the only bank in Italy certified by the National Transplant Center (Cnt) and the only one included in the European Compendium of Tissue Institutes. In the previous months, again by virtue of this agreement, ovarian tissue taken from three young women in oncological therapy had been sent from the Gemelli Polyclinic.
The surgery was carried out by Lorenzo Nanni, director of the Gemelli pediatric surgery unit, in collaboration with Giacomo Corrado, coordinator of the Oncofertility clinical care path of the polyclinic. “A very important aspect – explains Corrado – is that, until the signing of this agreement, to carry out the ovarian tissue sampling it was necessary to transfer the patient to the Ifo Bank, but this discouraged many patients who ended up giving up this possibility. (Since 2018, 18 have accepted, including two girls.) Thanks to this agreement it is no longer necessary to transfer the patient, because the collection can be made directly to the Gemelli Polyclinic from where it is then sent to the Ifo Bank for cryopreservation “. At the moment, this one of Gemelli, together with that stipulated with the Bambino Gesù Pediatric Hospital in Rome, are the only agreements of this type active in Italy with the Banca della Regione Lazio.
The girl underwent sarcoma removal surgery in May and later, on 5 July, ovarian tissue removal. “The intervention – recalls Nanni – is the last link in a chain, which comes after an impressive elaboration to create this agreement. The child is in excellent condition and the removal of ovarian tissue does not involve the patient in an important way. performed laparoscopically, in this case with three accesses (‘holes’) on the abdomen, one for the optics and two for the instruments. The procedure is simple from the laparoscopic point of view, if the abdomen has not already been subjected to surgery, and lasts half an hour in all “.
“The child – reports Antonio Ruggiero, director of pediatric oncology at Gemelli and professor of pediatric oncology – was suffering from an undifferentiated cell sarcoma of the soft tissues of the pubic area, which appeared as a swelling. Fortunately, the tumor had not yet metastasized. therefore we are optimistic about the prognosis of our patient. The treatment of these tumors involves surgical removal, followed by systemic treatment (chemotherapy) and sometimes even radiotherapy. Given the need to undergo a chemotherapy treatment that can compromise fertility, it was offered the child and her family the opportunity to access this cryopreservation program “.
“Among pediatric tumors – specifies the specialist – those that could access this program are non-metastatic solid tumors that have to undergo chemotherapy. The possibility of this path is an added value to the treatments offered to Gemelli because, in addition to the best intervention and to the best therapy, we are already thinking about the future and the post-treatment quality of life of these patients and this prospect of recovery is reassuring for both patients and their families “.
Every year in our country about 5 thousand women under 40, therefore of reproductive age, are diagnosed with cancer. Advances in cancer therapy have led to significant long-survival rates (up to 85% in breast cancers and lymphomas), but at the same time systemic treatments can irreversibly damage women’s ovarian reserve, leading to infertility problems. . It is from these premises that the branch of oncofertility is born, a bridge discipline between oncology and reproductive endocrinology, which aims to preserve fertility. The Gemelli Irccs Polyclinic Foundation has dedicated a clinical assistance path to oncofertility, wanted by Giovanni Scambia, director of the Oncological Gynecology Unit and scientific director of the Polyclinic Foundation, and full professor of Gynecology at the Catholic University of the Sacred Heart, Rome campus.