Intrauterine progesterone treatment of early endometrial cancer.
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.
Montz
Fredrick J
FJ
Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Hospital and Medical Institutions, Baltimore, MD 21287, USA..
Bristow
Robert E
RE
Bovicelli
Alessandro
A
Tomacruz
Rafael
R
Kurman
Robert J
RJ
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*
D011374:Progesterone