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European Society of Gynecological Oncology Task Force for Fertility Preservation: Clinical Recommendations for Fertility-Sparing Management in Young Endometrial Cancer Patients
  1. Alexandros Rodolakis, MD, PhD*,
  2. Ioannis Biliatis, MD,
  3. Philippe Morice,§,
  4. Nick Reed,
  5. Mandy Mangler, MD#,
  6. Vesna Kesic** and
  7. Dominik Denschlag, MD, PhD,
  1. *First Department of Obstetrics and Gynecology, Athens University, Alexandra Hospital, Athens, Greece;
  2. Gynaecological Oncology Unit, Barts Health NHS Trust, London, United Kingdom;
  3. Gustave Roussy, Villejuif;
  4. §Institut National de la Santé et de la Recherche Médicale, Lyon;
  5. University of Paris, Paris, France;
  6. Beatson Oncology Centre, Gartnavel General Hospital, Glasgow, United Kingdom;
  7. #Department of Gynecology, Charité Campus Mitte, Berlin, Germany;
  8. **Department of Obstetrics and Gynecology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; and
  9. ††Gynäkologie und Geburtshilfe, Hochtaunus-Kliniken Bad Homburg, Bad Homburg, Germany.
  1. Address correspondence and reprint requests to Alexandros Rodolakis, MD, PhD, University of Athens, Alexandra Hospital, 80, Vas. Sofias ave, Athens 115 28, Greece. E-mail: rodolaki{at}hol.gr.

Abstract

Abstract Endometrial cancer (EC) in young women of reproductive age is a relatively rare diagnosis. However, since in the modern era women delay their childbearing for a variety of social reasons, more and more women in the near future will be nulliparous and have a diagnosis of EC at the same time. Hence, a more conservative approach of EC is desirable to preserve fertility of these women, without compromising their survival. Recently, the number of studies reporting encouraging results on fertility-sparing management of EC with high dose of progestins is increasing. It seems that preserving the uterus and the ovaries in a carefully selected patient with EC confers only a very small risk combined with an enormous benefit. Selection of women suitable for such a conservative approach, as well as method of treatment, follow-up, recurrence, obstetric outcomes, and survival rates are very important parameters when consulting women with EC wishing to preserve their fertility. In this article, we try to elucidate all the previously mentioned aspects and formulate clinical recommendations, based on published data, about the most proper approach and consultation of these patients.

  • Fertility sparing
  • Endometrial cancer
  • Progestins
  • Recurrence
  • Obstetric outcomes

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Footnotes

  • The authors declare no conflicts of interest.

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