title: Combined medroxyprogesterone acetate/levonorgestrel-intrauterine system treatment in young women with early-stage endometrial cancer.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of the combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment in young women with early-stage endometrial cancer who wish to preserve their fertility.
  
  
  METHODS
  A prospective observational study was conducted. The study population comprised women aged ≤40 years who were diagnosed with endometrioid endometrial cancer, grade 1, tumor size <2 cm presumably confined to the endometrium. A LNG-IUS was inserted in the uterine cavity of each woman, and all of the women received oral MPA (500 mg/d). Dilation was conducted every 3 months.
  
  
  RESULTS
  From September 2008 to December 2012, 16 patients were enrolled. The overall complete remission rate was 87.5% (14/16 patients); the average time to complete remission was 9.8 ± 8.9 months (range, 3-35 months). In the initial 3 months of treatment, complete remission was observed in 25% of cases (4/16 patients), partial response in 25% (4/16), and no change in 50% (8/16); there were no cases of progressive disease. Three patients achieved pregnancies. The average follow-up period was 31.1 ± 11.8 months (range, 16-50 months), and there were no treatment-related complications.
  
  
  CONCLUSIONS
  Combined oral MPA/LNG-IUS treatment is considered to be effective and favorable for young patients with early-stage endometrial cancer who want to preserve their fertility.
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: Mi Kyoung
authors.initials: MK
authors.lastname: Kim
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: You Shin
authors.initials: YS
authors.lastname: Kim
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.forename: Mi-La
authors.initials: ML
authors.lastname: Kim
authors.forename: Bo Sung
authors.initials: BS
authors.lastname: Yoon
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Jun
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018269:Carcinoma, Endometrioid / Q000188:drug therapy*; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate
keywords: endometrial cancer; levonorgestrel-intrauterine system (LNG-IUS); medroxyprogesterone acetate; progesterone