Introduction/Background Hormonal management is an alternative treatment for preserving fertility in patients with early stage endometrioid endometrial cancer (EC). The safety and clinical outcome in longer treatment more than 9 months has controversial. This study aimed to define the oncologic outcomes after hormone therapy more than 9 months for endometrioid EC.
Methodology We retrospectively analyzed patients presumed to have stage IA, grade 1–2 endometrioid EC who underwent fertility-sparing treatment. Concurrent medroxyprogesterone (MPA) and levonorgestrel-release intrauterine devices were used for treatment. The remission rate and progression free survival were analysed each of the short term treatment who had treatment under 9 months and long term groups who had treatment duration over 9 months.
Results One hundred twenty patients presumed to have stage IA, grade 1 endometrioid EC had treated with hormonal medication for fertility sparing. The median age was 33.5 (range 22–43) years old and the median treatment duration was 10.7 (3–102) months. The Complete remission (CR) rate was 84.2% (101/120) and the median time interval to CR was 9.3 (2–84) months. The median follow-up time was 32.9 (1–130) months. The recurrence rate was 31.7% (38/120) and the median time to recurrence was 11 (1–92) months. The cumulative CR rate by 3, 6, 9, 12, 15, 18, 24 months was 21.7%, 36.7%, 50.8%, 61.7%, 70.8%, 74.2%, and 78.3% respectively. The CR rates in group A and B were 86.7% and 82.7% in group A and B. The recurrence rates in two group wrere 35.6% and 29.3%, respectively.
Conclusion Fertility sparing treatment with high dose progestin over 9 months in early stage endometrioid EC has showed high rate of CR. However, medical treatment over 9 months should counsel with patients in detail and oncologists should make careful decision.
Disclosures I have no conflicts of interest to disclose.
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