title: Fertility sparing surgery for stage IA type I and G2 endometrial cancer in reproductive-aged patients: evidence-based approach and future perspectives.
abstract: Fertility-sparing surgery (FSS) in reproductive-age patients affected by endometrial cancer (EC) gained growing attention in the last decade, although the first reports were already published in 1990-2000s. Nevertheless, only few patients undergoing FSS for stage I, type I EC had been reported in each case series, without a robust multicenter study. In the available literature there are even fewer reported cases of conservative treatment of Stage IA and G2 EC. Considering these important gaps in our current knowledge, the purpose of this review was to summarize the available evidence about conservative treatments for stage IA type I and G2 EC, to improve the pretreatment counseling for reproductive-age patients. According to our overview, women who have low-risk disease (G1 or G2, endometrioid histotype confined to the endometrium) are candidates for progestin therapy. In addition, FSS could be considered a valid option for reproductive-aged patients with stage IA type I and G2 EC. Nevertheless, we solicit new trials to clarify the medium- and long-term outcomes in this kind of patients.
authors.affiliation: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via C. Valeria 1, 98125, Messina, Italy.
authors.forename: Salvatore Giovanni
authors.initials: SG
authors.lastname: Vitale
authors.affiliation: Department of Maternal and Child Health, Gavardo Hospital, Brescia, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Rossetti
authors.affiliation: Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tropea
authors.affiliation: Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Biondi
authors.affiliation: Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via C. Valeria 1, 98125, Messina, Italy. antlagana@unime.it.
authors.forename: Antonio Simone
authors.identifier: http://orcid.org/0000-0003-1543-2802
authors.initials: AS
authors.lastname: Laganà
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling; D016889:Endometrial Neoplasms / Q000601:surgery*; D019317:Evidence-Based Medicine; D005260:Female; D005298:Fertility; D006801:Humans; D011372:Progestins / Q000008:administration & dosage
chemical_list: D011372:Progestins
keywords: Endometrial cancer; Fertility-sparing surgery; Outcomes; Progestins; Reproduction