Fertility Preservation in Endometrial Cancer: Current Knowledge and Practice (2024)

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Conservative treatment for well-differentiated endometrial cancer: when and why it should be considered in young women

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Francesca Congiu

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Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics

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Walquíria Quida Salles Pereira Primo

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Georgios Androutsopoulos

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Frontiers in Oncology

Oncological outcomes in fertility-sparing treatment in stage IA-G2 endometrial cancer

Raffaela Maria Carotenuto

BackgroundThe gold standard treatment for early-stage endometrial cancer (EC) is hysterectomy with bilateral salpingo-oophorectomy (BSO) with lymphadenectomy. In selected patients desiring pregnancy, fertility-sparing treatment (FST) can be adopted. Our review aims to collect the most incisive studies about the possibility of conservative management for patients with grade 2, stage IA EC. Different approaches can be considered beyond demolition surgery, such as local treatment with levonorgestrel-releasing intra-uterine device (LNG-IUD) plus systemic therapy with progestins.Study designOur systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, EMBASE, and Scopus databases were consulted, and five studies were chosen based on the following criteria: patients with a histological diagnosis of EC stage IA G2 in reproductive age desiring pregnancy and at least one oncological outcome evaluated. Searc...

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Gynecologic Oncology

Conservative treatment of early endometrial cancer: Preliminary results of a pilot study

2011 •

Giuseppe Laurelli

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JBRA assisted reproduction

Fertility-Sparing Treatment in Young Women with Atypical Endometrial Hyperplasia and Low-Grade Endometrial Cancer: A Tertiary Center Experience

2020 •

Vaidyanathan Gowri

Objectives:To evaluate the oncologic and reproductive outcomes of patients with atypical endometrial hyperplasia and low grade stage 1 endometrial cancer who received medical treatment.Methods:We carried out a retrospective study on all patients aged 20-42 years with complex, atypical endometrial hyperplasia, and low-grade stage 1 endometrial cancer, who wished to preserve fertility and were treated at the Royal Hospital. We held this study between January 2006 and December 2016. The patients received oral megestrol acetate with or without a levonorgestrel intrauterine system. We assessed their response to progestin treatment in terms of treatment duration, time to response, pregnancy, time of surgery, and oncological outcome. We performed the statistical analysis using the SPSS 20.0 software.Results:Twenty patients met the inclusion criteria, and among them 90% had complete remission. Among these 90%, 55% had complete remission within six months of treatment. The recurrence rate was recorded in 11 patients (55%) and it was more frequent in obese patients with body mass index (BMI) ≥30 (p=0.001), who had complete response in > 6 months of hormonal treatment. About 15% of the patients required hysterectomy, and 12 (60%) patients conceived after full treatment.Conclusions:Fertility-sparing treatment of atypical endometrial hyperplasia and grade 1 stage 1 endometrial cancer in reproductive-age women is feasible. However, obese patients (BMI ≥ 30) had a higher recurrence rate.

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Fertility sparing surgery for stage IA type I and G2 endometrial cancer in reproductive-aged patients: evidence-based approach and future perspectives

Diego Rossetti

Fertility-sparing surgery (FSS) in reproductive-age patients affected by endometrial cancer (EC) gained growing attention in the last decade, although the first reports were already published in 1990–2000s. Nevertheless , only few patients undergoing FSS for stage I, type I EC had been reported in each case series, without a robust multicenter study. In the available literature there are even fewer reported cases of conservative treatment of Stage IA and G2 EC. Considering these important gaps in our current knowledge, the purpose of this review was to summarize the available evidence about conservative treatments for stage IA type I and G2 EC, to improve the pretreatment counseling for reproductive-age patients. According to our overview, women who have low-risk disease (G1 or G2, endometrioid histotype confined to the endometrium) are candidates for progestin therapy. In addition, FSS could be considered a valid option for reproductive-aged patients with stage IA type I and G2 EC. Nevertheless, we solicit new trials to clarify the medium-and long-term outcomes in this kind of patients.

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Taiwanese Journal of Obstetrics and Gynecology

Hormone therapy for younger patients with endometrial cancer

2012 •

Edmond Hsieh

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İşletme ve Ekonomi Araştırmaları Dergisi

Turkiye Ekonomisi Nde Yasanan 1994 2001 Ekonomik Krizlerinin Ve 2008 Kuresel Ekonomik Krizinin Imalat Sanayi Sektorune Etkilerinin Finansal Oranlar Ile Incelenmesi

2013 •

Reşid çiğdem

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Acta Bio Medica : Atenei Parmensis

Conservative treatment in early stage endometrial cancer: a review

2019 •

Raffaele Tinelli

Endometrial Cancer (EC) is the commonest gynecological cancer and its incidence is increasing. The diagnosis of endometrial carcinoma in young women of childbearing age is rare. Indeed, only 4% of patients with endometrial carcinoma are <40 years of age. It’s typically diagnosed in postmenopausal women. The standard approach for the management of endometrial cancer in young women of childbearing age is hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy but is not ideal for women interested in future fertility. We reviewed the published literature to clarify in fertile women who have not yet fulfilled their desire for motherhood, what are the strategies, the risks of a conservative treatment of early stage of Endometrial Cancer and what are the obstetric outcomes in this patients. Recently, several studies have reported encouraging results on fertility-sparing management of EC with high dose of progestins in selected women associated or not with hyste...

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Fertility Preservation in Endometrial Cancer: Current Knowledge and Practice (2024)
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