Introduction/Background*The aim of our study is to evaluate the oncological and perinatal outcomes in young women diagnosed with atypical endometrial hyperplasia (AH) or endometrial cancer (EC) treated with hormone therapy.
Methodology A single institutional ambispective study was performed including all patients diagnosed with AH or EC grade 1 without myometrial invasion who received hormone therapy between January 2011 and July 2021. We analyzed the complete response rate and recurrence rate of disease and pregnancy rate in these patients as well as perinatal results (live births rate, type of delivery and perinatal morbidity). In addition, we evaluated complete response rate according to type of hormone therapy, dosage received and treatment length.
A review of literature was performed to identify studies involving patients with AH or EC who received fertility sparing management.
All statistical analysis were performed using the software SPSS Statistics v.24.0 (IBM Corp., Armonk, NY, USA).
Result(s)*There were 6 patients with AH/EC (4 and 2 patients respectively) who received hormone therapy with a mean treatment time of 8.6±1.96 months. Hormone therapy with megestrol acetate was carried out in 4 patients (66.6%). Complete remission was achieved in 5 patients (83.3%) and 2 of them (33.3%) attempted pregnancy. Finally, no complications during pregnancy were reported in this 2 patients and both had normal delivery. The rate of live birth was 33.3%. During the follow-up no recurrences were detected and overall survival was 100%
Conclusion*Conservative management with progestins of young patients with AH or EC grade 1 limited to the endometrium is an acceptable possibility given the high remission rate and live birth rates achieved. However, definitive surgical treatment cannot be avoided given the high recurrence rate described in the literature.
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