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Fertility-preserving treatment in young women with endometrial adenocarcinoma: a long-term cohort study
- Source :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 24(4)
- Publication Year :
- 2014
-
Abstract
- ObjectiveGrowing evidence suggests that fertility-preserving treatment is feasible for young women with early-stage, low-grade endometrial carcinoma. However, published data on their long-term outcomes and prognostic factors remain scanty. We aimed to investigate the outcomes of young women receiving fertility-preserving treatment.MethodsBetween 1991 and 2010, the outcomes of young women with grade 1 endometrioid endometrial carcinoma at presumed stage IA (without myometrial invasion) who underwent fertility-preserving treatment of megestrol acetate 160 mg/d with or without other hormonal agents were retrospectively analyzed.ResultsWe identified 37 eligible patients (median age, 32 years; range, 18–40 years). The median follow-up time was 78.6 months (range, 19.1–252.8 months). Complete response (CR) lasting more than 6 months was achieved in 30 (81.1%) women. Responders were significantly younger than nonresponders (P= 0.032). Of the 30 women who had a CR, 15 (50.0%) had disease recurrence. The 5-, 10-, and 15-year cumulative recurrence-free survival rates were 51.0%, 51.0%, and 34.0%, respectively. Notably, those recurred were significantly older (P= 0.003), and the time to CR was significantly longer (P= 0.043) than those without recurrence. One patient developed late recurrences at 156 months, and 2 patients developed ovarian metastasis (6 and 137 months from diagnosis). All the patients are currently alive.ConclusionsThis study demonstrates the feasibility of high-dose megestrol acetate–based therapy for fertility preservation. The substantial risk of late recurrences highlights the need for long-term follow-up studies of large sample sizes with in-depth tumor and host molecular signatures.
- Subjects :
- Oncology
Adult
medicine.medical_specialty
Time Factors
Adolescent
Antineoplastic Agents, Hormonal
media_common.quotation_subject
Fertility
Disease
Adenocarcinoma
Young Adult
Internal medicine
medicine
Carcinoma
Humans
Fertility preservation
Stage (cooking)
media_common
Neoplasm Staging
Retrospective Studies
Endometrial adenocarcinoma
business.industry
Obstetrics and Gynecology
Fertility Preservation
medicine.disease
Prognosis
Survival Rate
Megestrol acetate
Female
Neoplasm Recurrence, Local
business
Carcinoma, Endometrioid
medicine.drug
Cohort study
Follow-Up Studies
Subjects
Details
- ISSN :
- 15251438
- Volume :
- 24
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
- Accession number :
- edsair.doi.dedup.....7e6dd426754497c6455a03b150af3e2a