Weiwei Shan1,2, Pengfei Wu1,2, Bingyi Yang1,2, Hongwei Zhang2,3, Li Sun2,4, Qiaoying Lv1,2, Xuezhen Luo1,2, Yali Cheng1,2, Qin Zhu2,5, Xiaojun Chen1,2. 1. Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. 2. Department of Gynecology, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China. 3. Department of Cervix, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. 4. Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. 5. Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Abstract
PURPOSE: To explore the clinical outcomes of megestrol acetate alone or plus metformin in young women with grade 2 stage IA endometrial carcinoma who ask for preserved fertility. METHODS: Patients with stage IA grade 2 endometrial carcinoma who asked for fertility-sparing treatment in the Obstetrics and Gynecology Hospital of Fudan University between 2015 and 2017 were enrolled and retrospectively reviewed. RESULTS: Four patients were included and treated with oral megestrol acetate (160 mg per day), while metformin (500 mg, thrice daily) was added for patients with metabolic syndrome. Regular hysteroscopic examination was performed every 3 months during the conservative treatment. Overall, 75% (3/4) of the patients had a complete response, one relapsed and achieved a complete response after changing the therapy plan, and one patient had an indication of myometrial invasion during fertility-sparing treatment and chose to remove uterus. CONCLUSIONS: Fertility-sparing treatment for stage IA grade 2 endometrial carcinoma patients is worth exploration. Megestrol acetate with or without metformin combined with hysteroscopic lesion ablation may be an effective therapy.
PURPOSE: To explore the clinical outcomes of megestrol acetate alone or plus metformin in young women with grade 2 stage IA endometrial carcinoma who ask for preserved fertility. METHODS:Patients with stage IA grade 2 endometrial carcinoma who asked for fertility-sparing treatment in the Obstetrics and Gynecology Hospital of Fudan University between 2015 and 2017 were enrolled and retrospectively reviewed. RESULTS: Four patients were included and treated with oral megestrol acetate (160 mg per day), while metformin (500 mg, thrice daily) was added for patients with metabolic syndrome. Regular hysteroscopic examination was performed every 3 months during the conservative treatment. Overall, 75% (3/4) of the patients had a complete response, one relapsed and achieved a complete response after changing the therapy plan, and one patient had an indication of myometrial invasion during fertility-sparing treatment and chose to remove uterus. CONCLUSIONS: Fertility-sparing treatment for stage IA grade 2 endometrial carcinomapatients is worth exploration. Megestrol acetate with or without metformin combined with hysteroscopic lesion ablation may be an effective therapy.
Authors: Pierluigi Giampaolino; Valeria Cafasso; Dominga Boccia; Mario Ascione; Antonio Mercorio; Francesco Viciglione; Mario Palumbo; Paolo Serafino; Cira Buonfantino; Maria Chiara De Angelis; Paolo Verrazzo; Giovanna Grasso; Giuseppe Gullo; Giuseppe Bifulco; Luigi Della Corte Journal: Biomed Res Int Date: 2022-09-27 Impact factor: 3.246