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Fertility‐sparing treatment in young women with endometrial cancer or atypical complex hyperplasia: a prospective single‐institution experience of 21 cases
Author(s) -
Signorelli M,
Caspani G,
Bonazzi C,
Chiappa V,
Perego P,
Mangioni C
Publication year - 2009
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2008.02024.x
Subject(s) - medicine , infertility , progestin , pregnancy , gynecology , prospective cohort study , fertility preservation , obstetrics , endometrial cancer , pregnancy rate , fertility , polycystic ovary , adverse effect , cancer , estrogen , surgery , population , insulin resistance , genetics , environmental health , insulin , biology
We conducted a prospective study of conservative treatment in 21 young nulliparous women with grade (G)1 endometrial cancer stage IA (11) or atypical complex hyperplasia (10). All were treated with a low‐dose cyclic natural progestin therapy (200 mg/day from day 14–25) and encouraged to attempt pregnancy immediately. No adverse therapy‐related effects were recorded. Overall response rate to progestin therapy was 57%. Nine women conceived (43%). There were 13 pregnancies, of which 13 were spontaneous and 8 were in women with persistent disease or partial response to hormonal treatment. Three additional complete responses were observed after delivery. Only women with known primary infertility or severe polycystic ovary syndrome showed inadequate pregnancy rate. Fifteen women underwent definitive surgery after enrolment (median 27 months, range 3–56 months). All 21 women are alive and disease free after a median follow up of 98 months.