| Objective:This study summarized the oncologic outcomes of twenty-two patients with early stage endometrial carcinoma (EC) and severe atypical hyperplasia (AH) who underwent surgery treatment after fertility-preserving therapy by progestin, and analyzed their surgery-relating factorsMethods:We reviewed the medical records of twenty-two cases of 140 patients younger than 45 years old with EC (FIGO Stage Ia) or AH who desired to preserve their fertility and were treated with oral progestin at Peking Union Medical College Hospital between November 1991 and May 2015. Patients were treated by continuous oral administrated MA 160-320mg/d or MPA 250-500mg/d until complete remission was achieved or severe adverse effects came out or disease progressed. Diagnosis and assessment of response to treatment were based on the results of dilatation and curettage, and hysteroscopy was used for biopsy of focal endometrial lesions or a more accurate endometrial curettage. Follow-up endometrial biopsy was performed every 3 months. Individualized treatment therapy was administered after achieving pathologic complete response.Results:At initial diagnosis,89 patients had grade 1 EC and 51 had AH. Median age of all the patients was 31 years old. One hundred and two cases (72.9%) achieved CR, and 11 (7.8%) got PR, while 5 (3.6%) got SD and 1 (0.7%) got PD. The median follow-up duration from the start of progestin was 26 months (range,3-152). Twenty-two of them finally underwent a hysterectomy. The surgical rate of patients who were under 35 years old and who were over 35 years was 13.3% and 41.7% respectively. Patients over 35 years old were linked to significantly higher rate of surgery.Conclusion:Progestin fertility-preserving therapy is an alternative treatment for patients with early stage endometrial carcinoma or severe atypical hyperplasia who desire to preserve fertility. Patients over 35 years old had more possibility of surgery. |
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