Introduction/Background Hysterectomy in endometrial cancer (EC) results in the loss of fertility and is often an unacceptable treatment for women of childbearing age. Hormone therapy has been suggested to preserve fertility, but side effects of systemic administration may lead to treatment failure. Currently, levonorgestrel-releasing intrauterine system (Mirena®) can be used as an alternative to oral/systemic progestins. The aim of the study was to evaluate the effectiveness of hormone therapy in patients with EC Stage 1A of reproductive age.
Methodology From 01.2017 to 01.2023 34 patients with EC Stage IA (FIGO 2018), Grade 1 were included. The mean age was 32.6 years (range 24 to 39).
The reproductive function was not realized in 29 (85.3%) women. 7 (20.5%) patients were diagnosed with polycystic ovary syndrome, 15 (44.0%) were obese (BMI ≥ 25 kg/m2).
Two treatment regimens were used 1) oral administration of Medroxyprogesterone acetate (Provera®) 500 mg per day for 6–9 months – in 14 cases; (2) Mirena® – in 20. The distribution into groups was carried out on the basis of the recommendations of the doctor and the choice of the patient.
The status of the endometrium was monitored every 3 months by ultrasound followed by endometrial biopsy.
Results A complete response was noted in 28 (82.4%) patients. In 6 (17.6%) cases, the effect was not achieved within a year of therapy.
The median follow-up was 37 months (range 6 to 66). During follow-up, 10 (29.4%) patients relapsed: 8 of 14 (57.1%, 95% CI: 28.86–82.34) after using oral Provera®, and 2 of 20 (10.0%, 95% CI: 1.23–31.70) - Mirena® (p=0.006).
Conclusion A complete response to hormonal therapy in patients with EC Stage 1A Grade 1 was observed in 82.4% of cases. The recurence rate was higher in patients with Provera® administration than after using the Mirena® (57.1% vs. 10.0%, p=0.006).
Disclosures Authors do not have any disclosures
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