Conservative surgical management of stage IA endometrial carcinoma for fertility preservation.
OBJECTIVE
To describe an innovative method to preserve fertility in young women with stage IA endometrial cancer with use of hysteroscopic resection followed by administration of 160 mg of megestrol acetate.


METHODS
Prospective study.


METHODS
Division of Gynecologic Oncology, Catholic University of the Sacred Heart, and the Endoscopic Gynecologic Unit, Nuova Villa Claudia, Rome, Italy.


METHODS
Six young patients with stage IA endometrial cancer.


METHODS
Conservative resectoscopic treatment using a three-step technique in which each step is characterized by a pathologic analysis: the removal of the tumor (step 1), the removal of the endometrium adjacent to the tumor (step 2), and the removal of the myometrium underlying the tumor (step 3).


METHODS
Therapy of stage IA endometrial cancer and pregnancy.


RESULTS
The conservative surgery was effective because results of transvaginal ultrasound examination and diagnostic hysteroscopy with target biopsies at 3, 6, 9, and 12 months after surgery were negative for atypia or malignancy. Moreover, four out of six patients (66%) achieved childbearing.


CONCLUSIONS
This method, under a close postsurgical follow-up, might represent a novel therapeutic option for those women with stage IA endometrial cancer who wish to preserve fertility.
Mazzon
Ivan
I
Endoscopic Gynecologic Unit, Nuova Villa Claudia, Via Flaminia Nuova, 280-00191 Rome, Italy. i.mazzon@arborvitae.it
Corrado
Giacomo
G
Masciullo
Valeria
V
Morricone
Daniela
D
Ferrandina
Gabriella
G
Scambia
Giovanni
G
D000328:Adult; D019468:Disease Management; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D005260:Female; D005298:Fertility / Q000187:drug effects / Q000502:physiology; D020249:Hormone Replacement Therapy / Q000379:methods; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*