Prognosis after fertility-sparing management with oralprogestin for women with complex endometrial hyperplasia and endometrial cancer
- VernacularTitle:高效孕激素治疗子宫内膜复杂不典型增生及子宫内膜癌的预后分析
- Author:
Yan LI
;
Ming CHEN
;
Ying JIN
;
Ying SHAN
;
Lingya PAN
- Keywords:
complex endometrial hyperplasia;
endometrial cancer;
fertility-sparing treatment;
progestin therapy
- From:
Basic & Clinical Medicine
2017;37(4):436-442
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the oncologic and reproductive outcomes after progestin treatment of complex endometrial hyperplasia(CEH) and grade 1 endometrial carcinoma(EC).Methods In a retrospective study, data were obtained for patients with CEH or grade 1 EC at presumed stage IA(without myometrial invasion) who wished to preserve fertility and were treated at the Peking Union Medical College Hospital, China, between January 1, 2000 and December 31, 2011.Patients had received oral medroxyprogesterone acetate(250-500 mg/d) or megestrol acetate(160-480 mg/d) for at least 6 months.Results Among 55 included patients, median age was 32 years(range 21-41 years).41(75%) achieved complete response after a median period of 6(3-24) months.Complete response was less frequent among obese than nonobese patients(4/12 [33%] vs 37/43 [86%];P=0.001).Disease recurrence was recorded in 10(24%) patients with complete response;the 5-year recurrence-freesurvival rate was 71%.Among the 33 patients who retained a desire to conceive, 17(52%) became pregnant.Conclusions Fertility-sparing management with oral progestin is effective and safe.Obesity is associated with a lower probability of long-term success.
