Prolonged conservative treatment of endometrial cancer patients: More than 1 pregnancy can be achieved

Tamar Perri, Jacob Korach, Walter H. Gotlieb, Mario Beiner, Dror Meirow, Eddie Friedman, Alex Ferenczy, Gilad Ben-Baruch

Research output: Contribution to journalArticlepeer-review

Abstract

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 levonorgestrelreleasing 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.

Original languageEnglish
Pages (from-to)72-78
Number of pages7
JournalInternational Journal of Gynecological Cancer
Volume21
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • Conservative treatment
  • Endometrial carcinoma
  • Fertility preservation
  • Progestins

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