P–447 Challenging cases in Oncofertility: Insights from a national specialized e-meeting for fertility preservation specialists
Authors: Khiat S , Pibarot M , Roux J , Bottin P , Saïas-Magnan J , Rives N , Courbiere B 
Published: August 2021

Abstract

Study question
How a new specialized e-meeting for complex cases in oncofertility is used by fertility preservation specialists (FPS)?

Summary answer
The e-meeting for complex oncofertility cases is an innovative tool that fulfils the needs of FPS and could help them to improve their oncofertility practice.

What is known already
Little is known about the management of fertility preservation (FP) in rare cancer that could be challenging for FPS due to lack of experience and scientific data. To our knowledge, there is no specially dedicated meeting reported in published literature to provide highly specialized advices to FPS in these challenging situations of FP.

Study design, size, duration
We present three years of activity of a national French e-meeting dedicated to the management of challenging oncofertility cases. We conducted a retrospective analysis of all submitted cases. Second, a survey was conducted to evaluate the use of this e-meeting at participating FPS.

Participants/materials, setting, methods
The E-meeting for Complex Cases in Oncofertility was created in 2016 September in France, allowing for National oncofertility experts to share viewpoints about challenging cases for which they do not have experience and/or no sufficient data available in published literature. Demographic and clinical data, number of replies and proposal for each case were collected retrospectively. A survey to investigate the use and the interest of FPS for this tool was sent to its members. Main results and the role of chance: One hundred and four experts have joined the e-meeting since its set-up and 109 challenging cases have been submitted. Mean age of patients was 22.0 ± 8.9 years old and 87% were female. Most of cases were hematological cancers (n = 32/109; 29%), gynecologic cancers (n = 30/109; 27%) and neurological cancers (n = 12/109; 10.9%). Each submitted case received on average 2 ± 1 different strategy for FP and the opinion of 7 ± 2 experts. Among the FPS who submitted cases, seeking the opinions from others FPS allowed them to confirm their care plan (N = 49; 84%), to offer different options to their patient (N = 34; 58%) and to compare their practices with other specialists (N = 23; 39%). All respondents reported a self-perceived improvement in their practice of oncologic FP (n = 80; 100%).

Limitations, reasons for caution
Although this study showed a perceived improvement at FPS in the management of challenging oncofertility cases, we did not study in details their adherence to the e-meeting’s proposals. The value of this new tool has also not been assessed regarding patient’s quality of life and further fertility.
Wider implications of the findings: Specific attention should be paid for challenging cases in oncofertility for which only experiences of individual exist. Enhancing communication between FPS through national and international networks, pooling experiences and collecting the most complex cases are required in order to improve the management of these patients.

Trial registration number
Not applicable