Literature DB >> 29121428

Efficacy of medroxyprogesterone acetate treatment and retreatment for atypical endometrial hyperplasia and endometrial cancer.

Satoshi Tamauchi1, Hiroaki Kajiyama1, Fumi Utsumi1, Shiro Suzuki1, Kaoru Niimi1, Jun Sakata1, Mika Mizuno2, Kiyosumi Shibata3, Fumitaka Kikkawa1.   

Abstract

AIM: Medroxyprogesterone acetate (MPA) is used to preserve fertility in patients with Grade 1 endometrial cancer without myometrial invasion (G1EA) and those with atypical endometrial hyperplasia (AEH). However, the efficacy of retreatment with MPA has not been sufficiently established for patients who experience recurrence but wish to retain their fertility. This study aimed to show the effectiveness of MPA treatment and retreatment for AEH and G1EA.
METHODS: A total of 39 patients received MPA treatment between 2005 and 2015, including nine with G1EA and 30 with AEH. The patients received high-dose (600 mg/day) MPA for 26 weeks. If a complete response was not achieved, MPA treatment was continued. After complete remission, if there was a recurrence, the patient was offered a choice of a hysterectomy or retreatment with MPA. The gynecologic and obstetric outcomes were retrospectively analyzed.
RESULTS: The median age was 34 years, and the median body mass index was 23.3 kg/m2 . The median follow-up period was 52 months. Complete response rates for the initial treatment were 89% for G1EA and 93% for AEH. Recurrence occurred in 88% of patients with G1EA (7/8) and 50% of those with AEH (14/28). Seven patients with G1EA and 11 with AEH received MPA retreatment, and 100% and 92% of these achieved a complete response. During the study period, a total of 14 pregnancies were recorded with 10 live births.
CONCLUSION: MPA can be effective for G1EA and AEH treatment even when they recur.
© 2017 Japan Society of Obstetrics and Gynecology.

Entities:  

Keywords:  atypical endometrial hyperplasia; endometrial cancer; fertility-sparing therapy; high-dose medroxyprogesterone acetate

Mesh:

Substances:

Year:  2017        PMID: 29121428     DOI: 10.1111/jog.13473

Source DB:  PubMed          Journal:  J Obstet Gynaecol Res        ISSN: 1341-8076            Impact factor:   1.730


  8 in total

1.  ESGO/ESTRO/ESP Guidelines for the management of patients with endometrial carcinoma.

Authors:  Nicole Concin; Carien L Creutzberg; Ignace Vergote; David Cibula; Mansoor Raza Mirza; Simone Marnitz; Jonathan A Ledermann; Tjalling Bosse; Cyrus Chargari; Anna Fagotti; Christina Fotopoulou; Antonio González-Martín; Sigurd F Lax; Domenica Lorusso; Christian Marth; Philippe Morice; Remi A Nout; Dearbhaile E O'Donnell; Denis Querleu; Maria Rosaria Raspollini; Jalid Sehouli; Alina E Sturdza; Alexandra Taylor; Anneke M Westermann; Pauline Wimberger; Nicoletta Colombo; François Planchamp; Xavier Matias-Guiu
Journal:  Virchows Arch       Date:  2021-02       Impact factor: 4.064

2.  Weight control is vital for patients with early-stage endometrial cancer or complex atypical hyperplasia who have received progestin therapy to spare fertility: a systematic review and meta-analysis.

Authors:  Miaomiao Li; Tao Guo; Ran Cui; Ying Feng; Huimin Bai; Zhenyu Zhang
Journal:  Cancer Manag Res       Date:  2019-05-06       Impact factor: 3.602

Review 3.  Clinical Use of Progestins and Their Mechanisms of Action: Present and Future (Review).

Authors:  T A Fedotcheva
Journal:  Sovrem Tekhnologii Med       Date:  2021-02-28

4.  Management of Recurrent Endometrial Cancer or Atypical Endometrial Hyperplasia Patients After Primary Fertility-Sparing Therapy.

Authors:  Junyu Chen; Dongyan Cao; Jiaxin Yang; Mei Yu; Huimei Zhou; Ninghai Cheng; Jinhui Wang; Ying Zhang; Peng Peng; Keng Shen
Journal:  Front Oncol       Date:  2021-09-09       Impact factor: 6.244

5.  Chances of pregnancy and live birth among women undergoing conservative management of early-stage endometrial cancer: a systematic review and meta-analysis.

Authors:  Erica Herrera Cappelletti; Jonas Humann; Rafael Torrejón; Pietro Gambadauro
Journal:  Hum Reprod Update       Date:  2022-02-28       Impact factor: 15.610

6.  Fertility-Sparing Treatment for Endometrial Cancer or Atypical Endometrial Hyperplasia Patients With Obesity.

Authors:  Junyu Chen; Dongyan Cao; Jiaxin Yang; Mei Yu; Huimei Zhou; Ninghai Cheng; Jinhui Wang; Ying Zhang; Peng Peng; Keng Shen
Journal:  Front Oncol       Date:  2022-02-18       Impact factor: 6.244

Review 7.  Contemporary Fertility-Sparing Management Options of Early Stage Endometrioid Endometrial Cancer in Young Nulliparous Patients.

Authors:  Gulzhanat Aimagambetova; Sanja Terzic; Antonio Simone Laganà; Gauri Bapayeva; Philip la Fleur; Milan Terzic
Journal:  J Clin Med       Date:  2021-12-30       Impact factor: 4.241

Review 8.  Fertility issue in early stage endometrial cancer patients.

Authors:  Hasan Onur Topçu; Cihan Kaya; Engin Oral
Journal:  Transl Cancer Res       Date:  2020-12       Impact factor: 1.241

  8 in total

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