Literature DB >> 14551001

Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer.

Walter H Gotlieb1, Mario E Beiner, Bruria Shalmon, Yaacov Korach, Yaacov Segal, Nissim Zmira, Joure Koupolovic, Gilad Ben-Baruch.   

Abstract

OBJECTIVE: To evaluate the safety of fertility-sparing hormonal therapy for endometrial cancer in young patients.
METHODS: We reviewed the clinical and pathologic records of patients diagnosed with endometrial adenocarcinoma before the age of 40, who were treated and followed over a 30-year period in the Division of Gynecologic Oncology. All patients who underwent conservative management with progestins (n = 13) are the subjects of this study.
RESULTS: Follow-up was available for all 13 patients, with a mean follow-up of 82 months. All patients responded to treatment within a mean period of 3.5 months, with normal pathology on follow-up endometrial samplings. Six patients had a recurrence within a period extending between 19 and 358 months (median 40 months). Four patients were treated with a second course of progestins, and all had a histologic complete response. As of the time of preparation of this report, nine healthy infants had been born, and all the patients remained without evidence of disease.
CONCLUSION: Conservative management of well-differentiated endometrial carcinoma in young patients, combined with assisted reproductive technologies, if needed, does not seem to worsen the prognosis. This approach also provides the possibility of conceiving and carrying a normal pregnancy.

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Year:  2003        PMID: 14551001     DOI: 10.1016/s0029-7844(03)00667-7

Source DB:  PubMed          Journal:  Obstet Gynecol        ISSN: 0029-7844            Impact factor:   7.661


  40 in total

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2.  Downregulation of FOXO1 mRNA levels predicts treatment failure in patients with endometrial pathology conservatively managed with progestin-containing intrauterine devices.

Authors:  Henry D Reyes; Matthew J Carlson; Eric J Devor; Yuping Zhang; Kristina W Thiel; Megan I Samuelson; Megan McDonald; Shujie Yang; Jean-Marie Stephan; Erica C Savage; Donghai Dai; Michael J Goodheart; Kimberly K Leslie
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Review 3.  Fertility preserving options in patients with gynecologic malignancies.

Authors:  Ramez N Eskander; Leslie M Randall; Michael L Berman; Krishnansu S Tewari; Philip J Disaia; Robert E Bristow
Journal:  Am J Obstet Gynecol       Date:  2011-03-16       Impact factor: 8.661

4.  Two cases of successful pregnancies after hysteroscopic removal of endometrioid adenocarcinoma grade I, stage IA, in young women with Lynch syndrome.

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Journal:  J Turk Ger Gynecol Assoc       Date:  2014-01-06

5.  Oncofertility in Canada: gonadal protection and fertility-sparing strategies.

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Review 6.  Clinical applications of levonorgestrel-releasing intrauterine system to gynecologic diseases.

Authors:  Mi-La Kim; Seok Ju Seong
Journal:  Obstet Gynecol Sci       Date:  2013-03-12

7.  Controversies in the management of endometrial cancer.

Authors:  V Masciullo; G Amadio; D Lo Russo; I Raimondo; A Giordano; G Scambia
Journal:  Obstet Gynecol Int       Date:  2010-06-16

8.  Controversies in the management of endometrial carcinoma.

Authors:  Ying Zhang; Jian Wang
Journal:  Obstet Gynecol Int       Date:  2010-06-22

9.  Absence of progesterone receptors in a failed case of fertility-sparing treatment in early endometrial cancer: a case report.

Authors:  Anna V Hoekstra; J Julie Kim; Pacita Keh; Julian C Schink
Journal:  J Reprod Med       Date:  2008-11       Impact factor: 0.142

10.  Progestin-releasing intrauterine device insertion plus palliative radiotherapy in frail, elderly uterine cancer patients unfit for radical treatment.

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