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Long‐term outcomes after progestogen treatment for early endometrial cancer
Author(s) -
Cade Thomas J.,
Quinn Michael A.,
Rome Robert M.,
Neesham Deborah
Publication year - 2013
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12142
Subject(s) - medicine , progestogen , curette , endometrial cancer , obstetrics , hysterectomy , pregnancy , gynecology , cancer , surgery , estrogen , biology , genetics
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. Aims 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.