Conservative treatment of early endometrial cancer: preliminary results of a pilot study.

Abstract

OBJECTIVE:

This study evaluated the feasibility and efficacy of combined operative hysteroscopy (HSC) and hormone therapy as fertility-preserving treatment in a cohort of selected young women with early endometrial carcinoma (EC).

METHODS:

Fourteen patients (median age 38 years, range 26-40) with FIGO stage IA (intramucous) EC wishing to preserve fertility were enrolled with the following inclusion criteria: age ≤40 years; no evidence of Lynch II syndrome; well-differentiated estrogen/progesterone receptor positive (ER+/PR+) endometrioid EC; no evidence of myoinvasion, multifocal tumor, node metastasis, ovarian mass; normal serum CA 125. Treatment consisted of hysteroscopic ablation of the lesion and the myometrial tissue below, followed by oral megestrol acetate (MA) 160 mg/day for 6 months (6 pts) or 52 mg levonorgestrel-medicated intrauterine device (LNG-IUD) for 12 months (8 pts).

RESULTS:

With a median follow-up of 40 months (range 13-79), one patient recurred after 5 months from operative HSC and underwent definitive surgery, one patient showed an endometrial hyperplasia without atypia at the 3 and 6 month HSC control, with negative controls thereafter. Three patients have attempted to conceive and one of them conceived and term delivered a healthy baby.

CONCLUSIONS:

Combined operative HSC and progestin therapy may have a role for safe and effective conservative management of early EC in selected patients wishing to preserve fertility.

• Authors: Giuseppe Laurelli, Giovanni Di Vagno, Cono Scaffa, Simona Losito, Maurizio Del Giudice, Stefano Greggi
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 120 Issue 1 Pg. 43-6 (Jan 2011) ISSN: 1095-6859 [Electronic] United States
• PMID: 21040953 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents, Hormonal
• Levonorgestrel
• Megestrol Acetate

Topics

• Adult
• Antineoplastic Agents, Hormonal (administration & dosage)
• Combined Modality Therapy
• Endometrial Neoplasms (drug therapy, pathology, surgery)
• Female
• Fertility
• Humans
• Hysteroscopy (methods)
• Intrauterine Devices, Medicated
• Levonorgestrel (administration & dosage)
• Megestrol Acetate (administration & dosage)
• Neoplasm Staging
• Pilot Projects
• Prospective Studies