Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer.
OBJECTIVE
To evaluate the safety of fertility-sparing hormonal therapy for endometrial cancer in young patients.


METHODS
We reviewed the clinical and pathologic records of patients diagnosed with endometrial adenocarcinoma before the age of 40, who were treated and followed over a 30-year period in the Division of Gynecologic Oncology. All patients who underwent conservative management with progestins (n = 13) are the subjects of this study.


RESULTS
Follow-up was available for all 13 patients, with a mean follow-up of 82 months. All patients responded to treatment within a mean period of 3.5 months, with normal pathology on follow-up endometrial samplings. Six patients had a recurrence within a period extending between 19 and 358 months (median 40 months). Four patients were treated with a second course of progestins, and all had a histologic complete response. As of the time of preparation of this report, nine healthy infants had been born, and all the patients remained without evidence of disease.


CONCLUSIONS
Conservative management of well-differentiated endometrial carcinoma in young patients, combined with assisted reproductive technologies, if needed, does not seem to worsen the prognosis. This approach also provides the possibility of conceiving and carrying a normal pregnancy.
Gotlieb
Walter H
WH
Department of Gynecologic Oncology, The Chaim Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel. walter.gotlieb@mcgill.ca
Beiner
Mario E
ME
Shalmon
Bruria
B
Korach
Yaacov
Y
Segal
Yaacov
Y
Zmira
Nissim
N
Koupolovic
Joure
J
Ben-Baruch
Gilad
G
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D000328:Adult; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007044:Hysterectomy; D007557:Israel / Q000453:epidemiology; D008499:Medical Records; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011372:Progestins / Q000627:therapeutic use*; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
D011372:Progestins