title: Fertility-preserving treatment with progestin, and pathological criteria to predict responses, in young women with endometrial cancer.
abstract: BACKGROUND
  There are therapeutic dilemmas regarding conservative management of endometrial cancer in young women.
  
  
  METHODS
  We planned a prospective study to conservatively treat women aged under 40 years with clinical stage 1A, grade 1 endometrioid adenocarcinoma from 1999 to 2005. There were nine women (aged 28-40) who fulfilled the criteria, and medroxyprogesterone acetate (400 mg/day) was continued for 6 months. Curettage materials were pathologically evaluated according to our criteria including partial response (PR) (a small amount of cancer tissue with remarkable hormonal effects or atypical hyperplasia). To predict complete response (CR) to progestin, immunohistochemical staining for insulin-like growth factor type 1 receptor, phosphatase and tensin homolog deleted on chromosome ten, progesterone receptor (PgR), estrogen receptor and Ki67 were assessed.
  
  
  RESULTS
  Seven (78%) and two cases presented complete and PRs, respectively. Two patients developed recurrent disease 10 and 22 months after the last dilatation and curettage, and both had synchronous ovarian cancer. However, all nine patients were alive and disease-free for a mean of 39 months. Of eight married patients, four (50%) conceived and three delivered full-term singletons. CR was related to positive expression of PgR (P=0.008).
  
  
  CONCLUSIONS
  Patients with an initial PR can obtain CR after further treatment, and the PgR may be useful in predicting CR to fertility-preserving treatment in young women with endometrial cancer.
authors: Department of Obstetrics and Gynecology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku, Tokyo 160-0023, Japan. K3126oji@aol.com
authors: Koji
authors: K
authors: Yamazawa
authors: Makiko
authors: M
authors: Hirai
authors: Atsuya
authors: A
authors: Fujito
authors: Hirokata
authors: H
authors: Nishi
authors: Fumitoshi
authors: F
authors: Terauchi
authors: Hiroshi
authors: H
authors: Ishikura
authors: Makio
authors: M
authors: Shozu
authors: Keiichi
authors: K
authors: Isaka
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D005260:Female; D005298:Fertility / Q000187:drug effects; D006801:Humans; D019394:Ki-67 Antigen / Q000096:biosynthesis; D011247:Pregnancy; D011372:Progestins / Q000627:therapeutic use*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D019394:Ki-67 Antigen; D011372:Progestins; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone