title: Long-term outcomes after progestogen treatment for early endometrial cancer.
abstract: BACKGROUND
  For select women with early endometrial cancer, particularly nulliparous women, nonsurgical options may be considered. There is increasing experience using progestogens, but little is known about the long-term outcomes and safety of such treatment.
  
  
  OBJECTIVE
  To present the cancer and pregnancy outcomes of women with greater than five years follow-up after progestogen treatment for early endometrial cancer.
  
  
  METHODS
  Ten women who underwent greater than six months of continuous progestogen therapy for early endometrial cancer were included in the study. All were managed by a gynaecological oncologist at a major tertiary centre in Melbourne, Australia. The histology of each subsequent curette was recorded, as was the timing and histology of hysterectomy (if relevant), and the results of any subsequent pregnancies.
  
  
  RESULTS
  All ten women showed histological regression of cancer with no cases of recurrence on follow-up curette. Four of ten women have undergone hysterectomy with one case of occult disease persistence in a woman noncompliant with therapy. The mean follow-up time was 89 months (range 62-142 months), there were no deaths and no woman was lost to follow-up. All four women attempting pregnancy were successful. There were eight pregnancies and five live births.
  
  
  CONCLUSIONS
  This form of treatment appears to be successful and safe in the long term with good pregnancy outcomes. However, it is not standard and should be supervised in a specialised gynaecological oncology unit.
authors.affiliation: Royal Women's Hospital, Parkville, Victoria, Australia.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Cade
authors.forename: Michael A
authors.initials: MA
authors.lastname: Quinn
authors.forename: Robert M
authors.initials: RM
authors.lastname: Rome
authors.forename: Deborah
authors.initials: D
authors.lastname: Neesham
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D050498:Live Birth; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D011247:Pregnancy; D011372:Progestins / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011372:Progestins; D016912:Levonorgestrel; D017258:Medroxyprogesterone Acetate
keywords: endometrial; endometrial carcinoma; gestagens; hormone-releasing IUD; neoplasms; progestins