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1284 Is there a place for hysteroscopic resection in early stage endometrial cancer? A mini case series and literature review
  1. Tudor Andrei Butureanu,
  2. Ana-Maria Apetrei,
  3. Ioana Pavaleanu,
  4. Ana-Maria Haliciu,
  5. Razvan Vladimir Socolov and
  6. Raluca Balan
  1. Iasi, Romania


Introduction/Background Endometrial cancer is the most common gynecologic malignancy. It is often diagnosed in elderly women in an early stage. It can, sometimes affect women at fertile age and therefore less invasive fertility-spearing treatment and close follow-up should be thoroughly proposed. Since most of these malignancies are diagnosed in elderly women, most of them will have associated diseases and eventually post-surgery complications. Can we consider hysteroscopic resection in this patients to reduce post-operatively risks?

Methodology Three patients were addressed to our clinic for intermitent bleeding, one was a 50 years old premenopausal patient, another one a 75 years old woman and another patient of 60 years of age. All three patients had transvaginal Color Doppler ultrasound and MRI to assess the highly suspected symptomatology of malignancy. They were all addressed to hysteroscopic resection and for all three patients the pathology report was positive for endometrial endometrioid carcinoma, stage 1A. Finally, on all patients total hysterectomy was performed in a one to two month interval.

Results All three hysterectomy specimens were free from any malignancy. As the guidelines in our country, the Romanian Society of Obstetrics and Gynecology, do not stipulate that sentinel lymph node dissection is compulsory, we did not perform any further dissection. There were no recurrences after a 2 to 4 years follow-up period with no complementary treatment.

Conclusion All our patients were treated through hysterectomy but If hysteroscopic tumor resection followed by progestin therapy for early-stage endometrial cancer is a safe conservative treatment strategy, than hysteroscopic resection could also be an option for elderly patients who have associated high risk diseases and for whom ultrasound and MRI characteristics do not raise the suspicion for an advanced malignancy. We believe that further studies should also be conducted to better assess this conclusion.

Disclosures Authors have nothing to disclose.

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