Pregnancy outcome in patients with stage 1a endometrial adenocarcinoma, who conservatively treated with megestrol acetate
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- Shirali, E., Yarandi, F., Eftekhar, Z. et al. Arch Gynecol Obstet (2012) 285: 791. doi:10.1007/s00404-011-2021-8
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The most effective treatment of well-differentiated endometrial carcinoma is surgery. The aim of this study is the evaluation of megestrol acetate on young patients with well-differentiated endometrial cancer who wish to preserve their fertility, with regard to the receptors.
16 patients were treated initially with 160 mg/d of megestrol acetate and continued with 320 mg/d for non-responsive cases. All patients followed with FD&C and hysteroscopy. The responsive patients were referred to IVF group.
Response rate to hormonal therapy was 10/16 (62.5%). The mean time of responding was 7.5 months. Other six (37.5%) patients underwent total abdominal hysterectomy (TAH).
Of 10 patients who responded to hormonal therapy, one exited of the study because of her husband’s infertility. Two patients are under IVF. Three patients did not get pregnant and four patients became pregnant and finally underwent TAH.
All patients had progesterone receptors. Only one patient lacked estrogen receptors; who also responded to treatment.
Progestins treatment of these patients who want to have child may be useful, but close long-term follow-up is necessary. The evaluation of estrogen and progesterone receptors assay may be useful in predicting response to the treatment.