Sparing fertility in young patients with endometrial cancer.
The objective of this review is to recognize the characteristics of endometrial adenocarcinoma in young patients and to evaluate the published experience with conservative approach in patients with endometrial adenocarcinoma. We searched MEDLINE articles describing patients with endometrial adenocarcinoma who were treated with hormonal therapy. The search included articles published between January 1966 and January 2007. Endometrial carcinoma in patients under 45 years of age is an unusual condition that shows a more favorable pattern than in older patients. One hundred thirty three patients were found in the search. The average duration of hormonal therapy was approximately 6 months. The average response time was 12 weeks. Seventy six percent of patients treated with hormonal therapy had a complete response and the other 24% never responded to treatment. Of those who initially responded, 66% didn't show recurrence of disease. The other 34% had a relapse. There have been published 4 deaths of patients conservatively managed. A conservative approach in these patients can offer reasonable oncological security and the opportunity of fulfilling their maternal desires in selected cases. However, consideration should be taken regarding the potential adverse outcomes that have been recently published in the literature.
Chiva
Luis
L
Department of Gynecologic Oncology, MD Anderson International España, Madrid, Spain. lchiva@mdanderson.es
Lapuente
Fernando
F
González-Cortijo
Lucia
L
Carballo
Natalia
N
García
Juan F
JF
Rojo
Alejandro
A
Gonzalez-Martín
Antonio
A
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D005298:Fertility; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D009367:Neoplasm Staging; D011372:Progestins / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
D018931:Antineoplastic Agents, Hormonal; D011372:Progestins; D017258:Medroxyprogesterone Acetate