title: Intrauterine progesterone treatment of early endometrial cancer.
abstract: OBJECTIVE
  Our purpose was to assess the feasibility of using a progesterone-containing intrauterine device (IUD) to treat presumed Federation Internationale Gynecologie et d'Obstetrique (FIGO) stage IA, grade 1 endometrioid cancer in women at high risk for perioperative complications.
  
  
  METHODS
  Candidates were women with American Society of Anesthesiologists class III or IV grade 1 endometrioid cancer and no imaging evidence of myometrial invasion. Subjects underwent hysteroscopy, curettage, and IUD placement, followed by endometrial biopsy every 3 months for 1 year. The records of similar patients treated surgically during the 3 years before protocol initiation were reviewed for comparison.
  
  
  RESULTS
  Sixteen patients fulfilled study criteria. Fourteen consented to participation; one was excluded at the time of IUD placement (grade 2 disease identified) and one was lost to follow-up. Twelve subjects have been followed up to 36 months; results of biopsies were negative in 7 of 11 at 6 months and 6 of 8 at 12 months. No IUD-related complications, except for expulsion, occurred. Sixteen complications (one fatal) occurred in 9 of the 15 control patients.
  
  
  CONCLUSIONS
  Intrauterine progesterone appears to eradicate some cases of presumed stage IA, grade 1 endometrioid cancer in women at high risk for perioperative morbidity.
authors.affiliation: Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Hospital and Medical Institutions, Baltimore, MD 21287, USA..
authors.forename: Fredrick J
authors.initials: FJ
authors.lastname: Montz
authors.forename: Robert E
authors.initials: RE
authors.lastname: Bristow
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bovicelli
authors.forename: Rafael
authors.initials: R
authors.lastname: Tomacruz
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Kurman
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D001706:Biopsy; D003475:Curettage; D004333:Drug Administration Routes; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007436:Intrauterine Devices, Medicated; D008279:Magnetic Resonance Imaging; D008593:Menopause; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011374:Progesterone / Q000008:administration & dosage*; D014463:Ultrasonography; D014599:Uterus / Q000187:drug effects*
chemical_list: D011374:Progesterone