Introduction/Background This study evaluated the oncologic and pregnancy outcomes of progestin treatment for early endometrial cancer in young women.
Methodology We retrospectively analyzed the medical records of 82 patients younger than 45 years with early stage endometrial cancer who had received fertility-sparing management between 2006 and 2018. All of the patients were treated with medroxyprogesterone acetate (MPA) or megestrol acetate (MA) or combined MPA/levonorgestrel-intrauterine system (LNG-IUS).
Results Fifty-nine patients (72.0%) showed complete response (CR) after progestin therapy, and 19 (32.2%) of them experienced recurrence after median follow-up time of 29.2 months. Age ≥35 (p=0.011), body mass index (BMI) ≥25 (p=0.015), and myometrial invasion (p=0.002) were significantly negative factors associated with achieving CR. Multivariate analysis showed that myometrial invasion (hazard ratio [HR]=14.00, 95% confidence interval [CI] 2.45–80.14, p=0.003) was significantly associated with a higher risk of recurrence and maintenance treatment (HR=0.26, 95% CI 0.08–0.85, p=0.026), and assisted reproductive technology (ART) utilization (HR=0.20, 95% CI 0.06–0.66, p=0.008) were significantly associated with a lower risk of recurrence. Of the 24 (40.7%) patients who tried to conceive after CR, 21 (87.5%) patients underwent ART, 12 (50.0%) patients experienced pregnancy, 9 patients (75.0%) had live newborn infants.
Conclusion Fertility-sparing management for early endometrial cancer with progestin is significantly effective. Patients with maintenance treatment, ART utilization, and without myometrial invasion associated with a higher probability of long-term success.
Disclosure Nothing to disclose.
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