Original researchOutcome of fertility-sparing treatment with progestins in young patients with endometrial cancer
Section snippets
Material and methods
We retrospectively reviewed the charts of premenopausal women, diagnosed and treated for endometrial carcinoma over a 30-year period (1970–2000) in the Division of Gynecologic Oncology of a tertiary care center. All the patients who underwent fertility-sparing management with the use of progestins are the subjects of this report. We reviewed their inpatient, outpatient, and oncology charts and extracted relevant clinical information. Follow-up was available for all of the patients. Using the
Results
Out of 75 premenopausal patients, 13 (18%) who were diagnosed with endometrial carcinoma received progestins as the primary treatment modality for their cancer. The clinical characteristics of these patients are presented in Table 1. Age at presentation ranged from 23 to 40 years, with a mean age of 31 years. None of the patients had a family history consistent with hereditary non-polyposis colon cancer (HNPCC). All patients were white, nulliparous, and none suffered from hypertension or
Discussion
Endometrial carcinoma, especially in young patients, seems to have a favorable prognosis and to be highly hormone dependent. As early as the late 1960s, progestative treatment was reported in two patients with well-differentiated endometrial carcinoma. One patient went into regression and then became pregnant twice (Table 3).6 Since then, various studies (most of them case reports for a total of 88 patients; Table 3) have been published, but follow-up in these studies is limited (mean 32
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