Progestogen treatment options for early endometrial cancer.
OBJECTIVE
Premenopausal women with early endometrial cancer may wish to maintain their fertility, and for some patients non-surgical treatment options may be attractive. We have examined our own experience with such patients, as there are limited published data so far to support clear guidelines in this area.


METHODS
Retrospective analysis of a case series.


METHODS
Case series from a specialist gynaecological oncology unit in a major tertiary referral hospital.


METHODS
Sixteen patients receiving progestogen therapy for stage-1 endometrial cancer.


METHODS
We reviewed our experience of all patients receiving progestogen therapy for stage-1 endometrial cancer, and we particularly examined their cancer-free outcome and fertility potential.


METHODS
Response to treatment, duration of response, and subsequent pregnancies.


RESULTS
Of the 16 patients investigated, four received an oral progestogen, five received the levonorgestrel-releasing intrauterine system (Mirena), and seven received both forms of treatment. Ten patients (63%) responded to treatment, with a median time to response of 5.5 months. Six patients did not respond to treatment, but all were either early in treatment or opted for surgical management before the average time of response. No patient who responded had a later recurrence. The mean total follow-up time was 27 months (range 3-134 months), with no patient deaths. Three patients had successful pregnancies, with one patient having two children.


CONCLUSIONS
This form of treatment appears to be a realistic treatment option in selected patients in the closely supervised environment of a specialist gynaecological oncology unit.
Cade
T J
TJ
Royal Women's Hospital, Melbourne, Vic., Australia. tomcade@gmail.com
Quinn
M A
MA
Rome
R M
RM
Neesham
D
D
D000284:Administration, Oral; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003475:Curettage; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D018365:Neoplasm, Residual; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000517:prevention & control; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate