Efficacy and Safety of Fertility-sparing Treatment in Young Patients with Early Endometrial Cacinoma
|Course||Obstetrics and Gynaecology|
|Keywords||endometrial carcinoma progesterone fertility conservation|
Objective:To evaluate the efficacy and safey of fertility-sparing treatment with progestin in young patients with different grade of early endometrial carcinoma.Methods:Eleven patients with early endometrial carcinoma treated by progestin were analyzed retrospectively.Results:There were six patients who met the indications, the median age of whom was 29 years(range 25 to 31 years). All of them were nulligravida, All patients had a desire to maintain fertility,and five of them had a history of infertilty. For clinical stage, all were clinical stageⅠ, and the pathologic diagnosis were endometrioid adenocarcinoma (G1-G2) with lesions confined to the endometrial.The progesterone receptors were positive.The liver and rental function tests were normal. None of them suffered from obesity. Six patients obtained complete response (CR) with duration of treatment. The median time of initial response(IR) and CR is 3 month and 5.5 month. Four of the six patients delivered five babies. Three patients did not have IR to progesterone, and abandoned to preserve fertility. They received surgical treatment, and found out they had diseases of stage Ib, and one of them had a progression with gradeⅡtoⅢ. With avarege follow-up time of 57.4 months, no one had recurrence.Conclusions:It is possible to preserve fertility by the treatment progesterone of young patients with early endometrial cancer(stage la with G1 and a few of stage Ia with G1-G2). And they had chance to delivery babies after obtaining CR. But the progesterone seemed to be response poorly to most of the patients with grade G1-G2 and no response to patients with grade G2. Unfortunately patients who did not obtain CR may had a progression.