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Combined Oral Medroxyprogesterone/Levonorgestrel-Intrauterine System Treatment for Women With Grade 2 Stage IA Endometrial Cancer
  1. Ji Young Hwang, MD*,
  2. Da Hee Kim, MD*,
  3. Hyo Sook Bae, MD, PhD*,
  4. Mi-La Kim, MD, PhD*,
  5. Yong Wook Jung, MD, PhD*,
  6. Bo Seong Yun, MD, PhD*,
  7. Seok Ju Seong, MD, PhD*,
  8. Eunah Shin, MD and
  9. Mi Kyoung Kim, MD*
  1. * Departments of Obstetrics and Gynecology and
  2. Pathology CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea.
  1. Address correspondence and reprint requests to Mi Kyoung Kim, MD, Department of Obstetrics & Gynecology, CHA Gangnam Medical Center, CHA University, 566, Nonhyeon-ro, Gangnam-gu, Seoul 135-081, Republic of Korea. E-mail: rlaalrud80{at}hanmail.net.

Abstract

Objective The aim of this study was to evaluate the oncologic and pregnancy outcomes of combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment in young women with grade 2–differentiated stage IA endometrial adenocarcinoma who wish to preserve fertility.

Methods We retrospectively reviewed the medical records of patients with grade 2 stage IA endometrial adenocarcinoma who had received fertility-sparing treatment at CHA Gangnam Medical Center between 2011 and 2015. All of the patients were treated with combined oral MPA (500 mg/d)/LNG-IUS, and follow-up dilatation and curettage were performed every 3 months.

Results A total of 5 patients were included in the study. The mean age was 30.4 ± 5.3 years (range, 25–39 years). After a mean treatment duration of 11.0 ± 6.2 months (range, 6–18 months), complete response (CR) was shown in 3 of the 5 patients, with partial response (PR) in the other 2 patients. One case of recurrence was reported 14 months after achieving CR. This patient was treated again with combined oral MPA/LNG-IUS and achieved CR by 6 months. The average follow-up period was 44.4 ± 26.2 months (range, 12–71 months). There were no cases of progressive disease. No treatment-related complications arose.

Conclusions Combined oral MPA/LNG-IUS treatment is considered to be a reasonably effective fertility-sparing treatment of grade 2 stage IA endometrial cancer. Although our results are encouraging, it is preliminary and should be considered with experienced oncologists in well-defined protocol and with close follow-up.

  • fertility-sparing treatment
  • grade 2 endometrial cancer
  • hormonal therapy
  • LNG-IUS
  • MPA

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Footnotes

  • The authors declare no conflicts of interest.

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