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Effectiveness of high-dose progestin and long-term outcomes in young women with early-stage, well-differentiated endometrioid adenocarcinoma of uterine endometrium

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

We assessed the effectiveness of high-dose progestins as a conservative treatment in young women with endometrial adenocarcinoma.

Methods

We retrospectively reviewed the hospital data of patients with endometrial cancer that were managed conservatively. Of those women with grade 1 endometrioid endometrial adenocarcinoma, we included those who were younger than 40 years and in whom the disease was clinically confined to the endometrium. A complete response was defined pathologically as the absence of tissue with adenocarcinoma or hyperplasia.

Results

Fourteen patients were included. Their mean age was 30.0 ± 4.8 years and the mean follow-up period was 47.3 ± 29.7 months. Twelve patients received 30–500 mg/day medroxyprogesterone acetate and two received 160 or 240 mg/day megestrol acetate. The median duration of treatment was 6 months (range 3–15 months) and 13 (93%) patients showed a complete response. Endometrial pathology reappeared in four patients (4/13, 31%) including two relapses, three of whom developed after the patients gave birth. Six patients used a combined oral contraceptive or a progestin-releasing intrauterine device as a maintenance therapy and experienced no recurrence. Four women (4/7, 57%) conceived successfully seven times with assisted-reproductive technology. No adverse effects of the progestins or tumor-related death were noted.

Conclusions

High-dose progestin therapy can be an effective conservative treatment in young patients with well-differentiated early-stage endometrial cancer. If patients wish to preserve their fertility even after they have completed childbearing, maintenance therapy with a cyclic oral contraceptive or a progestin-releasing intrauterine device may be an option to prevent recurrence.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, College of Medicine, CHA University, 650-9, Yoksam-dong, Gangnam-gu, Seoul, 135-913, Korea

    Hyun Park, Jun Min Seok, Bo Sung Yoon, Seok Ju Seong & Chong Taik Park

  2. Department of Pathology, Kangnam CHA Hospital, College of Medicine, CHA University, Seoul, Korea

    Ji Young Kim & Jeong Yun Shim

Authors
  1. Hyun Park
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  2. Jun Min Seok
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  3. Bo Sung Yoon
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  4. Seok Ju Seong
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  5. Ji Young Kim
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  6. Jeong Yun Shim
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  7. Chong Taik Park
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Corresponding author

Correspondence to Seok Ju Seong.

Additional information

H. Park and J. M. Seok contributed equally to this study.

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Park, H., Seok, J.M., Yoon, B.S. et al. Effectiveness of high-dose progestin and long-term outcomes in young women with early-stage, well-differentiated endometrioid adenocarcinoma of uterine endometrium. Arch Gynecol Obstet 285, 473–478 (2012). https://doi.org/10.1007/s00404-011-1959-x

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  • DOI: https://doi.org/10.1007/s00404-011-1959-x

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