Fertility-sparing treatment in young women with atypical endometrial hyperplasia and low-grade endometrial cancer: A tertiary center experience

Sumaya Shikeli, Vaidyanathan Gowri*, Thuria Al Rawahi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To evaluate the oncologic and reproductive outcomes of patients with atypical endometrial hyperplasia and low grade stage 1 endometrial cancer who received medical treatment. Methods: We carried out a retrospective study on all patients aged 20-42 years with complex, atypical endometrial hyperplasia, and low-grade stage 1 endometrial cancer, who wished to preserve fertility and were treated at the Royal Hospital. We held this study between January 2006 and December 2016. The patients received oral megestrol acetate with or without a levonorgestrel intrauterine system. We assessed their response to progestin treatment in terms of treatment duration, time to response, pregnancy, time of surgery, and oncological outcome. We performed the statistical analysis using the SPSS 20.0 software. Results: Twenty patients met the inclusion criteria, and among them 90% had complete remission. Among these 90%, 55% had complete remission within six months of treatment. The recurrence rate was recorded in 11 patients (55%) and it was more frequent in obese patients with body mass index (BMI) ≥30 (p=0.001), who had complete response in > 6 months of hormonal treatment. About 15% of the patients required hysterectomy, and 12 (60%) patients conceived after full treatment. Conclusions: Fertility-sparing treatment of atypical endometrial hyperplasia and grade 1 stage 1 endometrial cancer in reproductive-age women is feasible. However, obese patients (BMI ≥ 30) had a higher recurrence rate.

Original languageEnglish
Pages (from-to)466-469
Number of pages4
JournalJornal Brasileiro de Reproducao Assistida
Volume24
Issue number4
DOIs
Publication statusPublished - 2020
Externally publishedYes

Keywords

  • Endometrial cancer
  • Endometrial hyperplasia
  • Fertility
  • Progestogens

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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