Introduction Obesity is a major risk factor in the development of endometrial cancer in young patients in the reproductive age group. Fertility sparing treatment is a viable option for a select group of patients with early endometrial cancer, and involves systemic and intra-uterine hormonal therapy. Weight loss has been associated with improved outcomes in this group. Bariatric surgery has been shown to be the most effective and durable method of weight loss in obese patients. However, there is a paucity of data studying the benefit of bariatric surgery as part of fertility sparing management.
Methods We present a retrospective case series of five patients who are undergoing fertility sparing treatment for early endometrial cancer, who also underwent bariatric surgery for treatment of obesity and related comorbidities. We aim to show early regression of endometrial cancer for all the patients and also report on the other health benefits of bariatric surgery.
Results All five patients in this series achieved regression of endometrial cancer within six months of undergoing bariatric surgery. They also achieved significant weight loss and three patients with obesity-related comorbidities had remission of these conditions. One patient conceived via in-vitro fertilization and delivered a healthy baby.
Conclusion/Implications Patients on fertility sparing treatment for endometrial cancer who underwent bariatric surgery achieved early cancer regression within six months, significant weight loss and resolution of obesity related comorbidities. Bariatric surgery could be a promising component of fertility sparing management for obese patients. Long term, prospective studies are required to confirm the benefits reported in this series.
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