Introduction/Background Obesity represents one of the main risk factors for endometrioid endometrial cancer (EC). Besides being responsible for a chronic inflammatory state and insulin-resistance, obesity exposes women to a higher level of estrogen, leading to endometrial diseases. Even though it’s not the standard treatment, a conservative approach with hysteroscopic surgery followed by progestinic therapies can be considered in selected patients diagnosed with atypical endometrial hyperplasia (AEH), endometrial intraepithelial neoplasia (EIN), and low-grade EC. By producing a sustained weight loss, bariatric surgery has been demonstrated to reduce both cancer risk and recurrence. The endoscopic sleeve gastroplasty (ESG) is a minimally invasive technique that mimics the restrictive parts of bariatric surgery. Thus, we aimed at analyzing the feasibility of combined conservative treatment and endoscopic bariatric approach for the treatments of young obese women wishing to preserve fertility with diagnosis of AEH, EIN or EC.

Methodology We retrospectively retrieved patients who underwent both conservative treatment for AEH, EIN or early EC and ESG at our Institution from January 2020. We will analyze clinical, gynecologic oncological, and weight loss data as well as obstetric outcomes.

Results Results on the patients retrieved will be presented in the late-breaking abstract.

Conclusion This preliminary study may provide further evidence of the impact of obesity in the natural history of endometrial diseases. In fact, after obtaining a better metabolic status thanks to ESG, we expect to find improved response rate in our population thus allowing a fertility sparing treatments for our young and obese patients, which are known to experience a worse response compared to normal weight patients.

Disclosures Prof. Scambia has the following disclosures: receipt of honoraria or consultation fees: Covidien AG, AstraZeneca/MSD; participation in a company sponsored speaker’s bureau: Olympus Europa, Baxter Healthcare, Intuitive Surgical Inc., GlaxoSmithKline

Prof. Zannoni has the following disclosures: Participation in a company sponsored speaker’s bureau: GlaxoSmithKline

Prof. Fanfani has the following disclosures: Participation in a company sponsored speaker’s bureau: MSD, GSK