Introduction/Background Surgical treatment of Endometrial cancer is associated with loss of fertility in young women. For young patients who desire future fertility, conservative management of uterine cancer has been advocated as a safe alternative to hysterectomy and bilateral salpingo-oophorectomy.
Methodology Patients with Endometroid endometrial cancer who have progesterone receptor more than 50% positivity, and serum CA-125 less than 30IU/ml are enrolled. Patients had no evidence of myometrial/cervical invasion, retroperitoneal lymph nodes involvement, ovarian tumors or distant metastases on transvaginal sonography, abdomen-pelvis magnetic resonance, and chest X-Ray examinations. Female patients who are younger than 40 years and have early stage endometrioid endometrial cancer were selected for the procedure. Interventions: Under general anesthesia; the uterine cervix is dilated to 9/9.5 mm with Hagar's dilators and an 8.5/9 mm resectoscope with a 0° lens is used. The uterine cavity is distended with 1.5% glycine solution with a pressure of 70 mm Hg. A 5-mm loop electrode and 100 W of pure cutting are used to resect the tumor. If the lesion is diffuse, multiple, large, electrode loop biopsy of both the endometrial mucosa and underlying myometrium are performed on the fundus, anterior, posterior, and lateral uterine walls. After one week, patients are prescribed Mega Acetate 120 mg daily for 6 months.
Results In all patients, intrauterine adhesions are not detected. Relapse of the disease is very small and full-term pregnancies achieved after the end of progestin therapy.
Conclusion Farghaly´s technique for hysteroscopic resection of the endometrium combined with progestin therapy for stage IA endometrioid endometrial cancer in young patients who wishes to preserve their fertility is safe and has satisfactory oncologic and reproductive outcomes.
Disclosure Nothing to disclose.
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