PT  - JOURNAL ARTICLE
AU  - Tamar Perri
AU  - Jacob Korach
AU  - Walter H. Gotlieb
AU  - Mario Beiner
AU  - Dror Meirow
AU  - Eddie Friedman
AU  - Alex Ferenczy
AU  - Gilad Ben-Baruch
TI  - Prolonged Conservative Treatment of Endometrial Cancer Patients: More Than 1 Pregnancy Can Be Achieved
AID  - 10.1097/IGC.0b013e31820003de
DP  - 2011 Jan 01
TA  - International Journal of Gynecologic Cancer
PG  - 72--78
VI  - 21
IP  - 1
4099  - http://ijgc.bmj.com/content/21/1/72.short
4100  - http://ijgc.bmj.com/content/21/1/72.full
SO  - Int J Gynecol Cancer2011 Jan 01; 21
AB  - Background: Preserving reproductive function in young patients with early endometrial cancer is an accepted concept today. The safety and feasibility of long-term conservative treatment, allowing more than 1 pregnancy, remain to be ascertained.Methods: This study was a retrospective chart review of a 27 women with endometrioid adenocarcinoma of the endometrium, who were treated conservatively at 2 tertiary-care institutions. Treatment comprised oral high-dose progestins with or without a levonorgestrel-releasing intrauterine device. Endometrial biopsy was repeated every 2 to 3 months.Results: Over 7.8 to 412 months (median, 57.4 months), tumors regressed completely in 24 (89%) of 27 patients and partially in 2 patients, with 79% responding within 1 to 17 months. Of the complete responders, 15 (62%) of 24 had a recurrence; 4 underwent hysterectomy, and 11 underwent subsequent progestational treatment. All 11 responded, and 3 subsequently conceived. After 2 to 4 years, 5 patients again had a recurrence, of whom 3 underwent hysterectomy. Overall, 2 patients developed ovarian adenocarcinoma. All patients are currently disease-free. Conception occurred in 14 (51.8%) of 27 patients, in 5 more than once. There were 17 live births, and 2 patients are pregnant.Conclusions: According to our data, prolonged progestational therapy for early-stage endometrial adenocarcinoma, allowing women to conceive, is feasible and apparently does not alter clinical outcome. Patients should be advised of the high recurrence rate and possible concomitant ovarian malignancy.