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Efficacy and pregnancy outcomes of hysteroscopic surgery combined with progestin as fertility-sparing therapy in patients with early stage endometrial cancer and atypical hyperplasia

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

Abstract

Purpose

This study aims to evaluate the efficacy of hysteroscopic curettage combined with progestin therapy in young patients with early-stage endometrial cancer (EC) and endometrial atypical hyperplasia (EAH) who wished to preserve their fertility.

Methods

This prospective cohort study included 16 patients with early-stage EC and 25 patients with EAH in Dalian Maternal and Child Health Hospital from August 2014 to October 2018. All patients received fertility-sparing therapy with hysteroscopic evaluation every 3 months until achieving complete response (CR). Demographic, clinical, and pathological data follow-up information as well as fertility outcomes was analyzed.

Results

There were 92.6% (37/41) patients who achieved CR. The mean treatment duration to CR was 7.47 ± 2.91 months. BMI ≤ 30 kg/m2 was associated with shorter treatment duration to achieve CR (P = 0.003). Among the patients who attempted to conceive, 30.3% (10/33) had successful pregnancy, and 18.2% (6/33) delivered live births. The implementation of assisted reproductive technology (ART) is closely associated with pregnancy (P = 0.001).

Conclusion

The fertility-sparing therapy, hysteroscopic curettage combined with progestin therapy, of early young EC and EAH patients is safe and effective. BMI is the main factor affecting the duration of CR. After achieving CR, ART can significantly improve the pregnancy rate of these patients.

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The datasets used and analyzed during the current study are included in this article.

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

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Authors and Affiliations

  1. Liaoning Provincial Hospital for Women and Children, No. 240, Shayang Road, Heping District, Shenyang, 110005, Liaoning, China

    Runqi Gong

  2. Dalian Municipal Women and Children’s Medical Center (Group), Dalian, 116033, Liaoning, China

    Yong Xi, Geng Liu, Dandan Liu & Jiyong Jiang

Authors
  1. Yong Xi
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  2. Geng Liu
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  3. Dandan Liu
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  4. Jiyong Jiang
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Contributions

YX: project development, data collection, manuscript editing and submission; GL: data analysis; DDL: data collection or management; JYJ: data collection; RQG: design and supervise the study. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Runqi Gong.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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All procedures performed in studies were in accordance with the ethical standards of the institutional and/or national research committee (the Dalian Municipal Maternal and Child Health Care Hospital) and with the 1964 Declaration of Helsinki and its later amendments.

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Xi, Y., Liu, G., Liu, D. et al. Efficacy and pregnancy outcomes of hysteroscopic surgery combined with progestin as fertility-sparing therapy in patients with early stage endometrial cancer and atypical hyperplasia. Arch Gynecol Obstet 307, 583–590 (2023). https://doi.org/10.1007/s00404-022-06626-w

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  • DOI: https://doi.org/10.1007/s00404-022-06626-w

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