title: Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer.
abstract: 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.
authors.affiliation: Department of Gynecologic Oncology, The Chaim Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel. walter.gotlieb@mcgill.ca
authors.forename: Walter H
authors.initials: WH
authors.lastname: Gotlieb
authors.forename: Mario E
authors.initials: ME
authors.lastname: Beiner
authors.forename: Bruria
authors.initials: B
authors.lastname: Shalmon
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Korach
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Segal
authors.forename: Nissim
authors.initials: N
authors.lastname: Zmira
authors.forename: Joure
authors.initials: J
authors.lastname: Koupolovic
authors.forename: Gilad
authors.initials: G
authors.lastname: Ben-Baruch
mesh_terms: 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
chemical_list: D011372:Progestins