RT Journal Article
SR Electronic
T1 #678 Fertility sparing treatment in women with complex atypical endometrial hyperplasia-our clinical experience
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A177
OP A177
DO 10.1136/ijgc-2023-ESGO.364
VO 33
IS Suppl 3
A1 Papakonstantinou, Aikaterini
A1 Panagakis, George
A1 Liakakos, Theodoros
A1 Sotirchos, Athanasios
A1 Papageorgiou, Dimitris
A1 Karaiskou, Akrivi
A1 Theofanakis, Charalampos
A1 Petrogiannis, Nikolaos
A1 Trachanas, Dimitrios
YR 2023
UL http://ijgc.bmj.com/content/33/Suppl_3/A177.1.abstract
AB Introduction/Background Complex atypical endometrial hyperplasia suggests a pre-malignant state of endometrial cancer which tends to occur in women of reproductive age. Oral progestins have been used as conservative treatment in young women with atypical endometrial hyperplasia who want to preserve their fertility. This treatment can be used alone or combined with Levonorgestrel-releasing intrauterine system (Mirena). LNG-IUD could be also used alone. The aim of our study was to evaluate the response of treatment in women who received oral progestins as monotherapy and others who were treated with LNG-IUD.Methodology We conducted a randomized prospective study, at the gynecological department of the Naval Hospital of Athens since 2019. We included women, 32–38 years old, with complex atypical endometrial hyperplasia, treated with oral progestins alone, compared to Levonorgestrel-releasing intrauterine device. The histology of the patients was reevaluated every 6 months by hysteroscopy and curettage.Results So far, 12 women wishing to preserve fertility, have been included in the study. Five patients received oral progestins alone and 4 out of 5 achieved disease regression. Five patients were treated only with LNG-IUD and are free of disease. Two quite obese patients were treated with a combination of LNG-IUD and oral progestins and are also free of disease.Conclusion Although a larger sample is needed, the preliminary results are encouraging. Both oral progestins and LNG-IUD are effective in women who undergo fertility sparing treatment. Megestrol acetate had higher and quicker remission rates than medroxyprogesterone acetate. Regarding disease regression, the LNG-IUD proved to be more effective. Furthermore, there were no side effects associated with the use of LNG-IUD, whereas one woman who received megestrol acetate experienced secondary adrenal insufficiency. After complete response, conception should be recommended. Maintenance therapy with strict follow-up can also be proposed to decrease recurrence, along with proper counseling over the safety of this approach.Disclosures No conflict of interest