Fertility Preserved Hysteroscopic Approach for the Treatment of Stage Ia Endometrioid Carcinoma. Issue 9 (1st November 2017)

• Record Type: Journal Article
• Authors: Wang, Fangfang; Yu, Aijun; Xu, Haichao; Zhang, Xiaojing; Li, Li; Lou, Hanmei; Yu, Hua; Lin, Jun
• Is Part Of: International journal of gynecological cancer. Volume 27:Issue 9(2017)
• Page Start: 1919
• Page End: 1925
• Publication Date: 2017-11-01
• Subjects: Endometrioid carcinoma -- Fertility preservation -- Hysteroscopy -- Progestin; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0000000000001109
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: This study aims to explore the feasibility of a hysteroscopic procedure combined with progestin therapy in young patients with stage Ia endometrioid carcinoma (EC) to avoid sterilization. Materials and Methods: Eleven young women with stage Ia EC (International Federation of Gynecology and Obstetrics grade 1) who were treated with a hysteroscopic approach combined with progestin from July 2004 to June 2016 were retrospectively analyzed and followed up to monitor their general recovery and pregnancy outcome. Results: The patients' median age was 27.3 years (range, 25–39 years). Comorbidities consisted of primary infertility in 8 patients, polycystic ovary syndrome in 4, uterine fibroids in 2, and diabetes in 1. The results of immunohistochemical analysis were positive for all estrogen and progestin receptors. After treatment, 9 patients attained complete remission, and 2 patients achieved partial remission. The results of peritoneal cytology in 4 patients were negative. As of this writing, 6 of the 11 patients have given birth to 7 infants, and 1 patient had an ectopic pregnancy. Two patients ultimately underwent radical resection. The average follow-up time was 82.3 months (range, 15 to 152 months), and all patients remain disease-free. Conclusions: Hysteroscopic surgery combined with progestin treatment for stage Ia EC in young patients to avoid sterilization was practical and may represent a new option for patients with stage Ia EC who wish to preserve their fertility.