Introduction/Background Endometrial cancer (EC) is the most common malignant tumour of the female genital tract in developed countries and the second in mortality. Incidence at young ages before fulfilling pregnancy wish is increasing. Considering that the loss of reproductive capacity will cause a great impact it is essential to offer fertility-preserving treatment (FPT).
Methodology It is a retrospective observational study of patients diagnosed with endometrial atypical hyperplasia (EAH) or EC in our centre between 2007–2020 who received FPT. The inclusion criteria were: FIGO stage IA grade 1, no birth wish fulfilled and <50 years old. The variables studied were: initial and maintenance treatment (hysteroscopic resection, oral progestins and LNG-IUD), remission rate of the disease and fertility results.
Results During the study period, 247 cases were diagnosed. 66 cases were under 50: 18 of whom opted for FPT. Among these patients, 10 were diagnosed with EAH and 8 with EC. In 11 patients, a hysteroscopic resection was performed and 5 achieved pregnancy with live birth. Those treated with oral progestins were 5 and only in one case was pregnancy achieved. Regarding remission rates, the pathological anatomy at diagnosis was compared with the hysterectomy specimen. 6 cases achieved pregnancy, 4 of them were EAH and 2 were EC; 4 of them underwent surgery, finding no disease in the surgical piece. 11 cases did not achieve pregnancy and 5 of them underwent surgery: only one case of remission was observed (diagnosed of EAH), while in the 4 cases there was no remission (all diagnosed of EC) and in 2 of them progression was seen.
Conclusion The variability in conservative treatment has led to highly heterogeneous results in terms of disease remission rate and live birth. Hysteroscopic resection at the beginning has shown the best results. Patients who achieve pregnancy could present better prognostic factors for remission.
Disclosures I have no potential conflict of interest to report.
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