Possibilities of reproduction after treatment for early endometrial cancer
Objective. To investigate whether early endometrial cancer can be treated and whether fertility can be preserved in young women, by using a hormonal combination: levonorgestrel intrauterine hormonal system (LNG-IUS; Mirena 52 mg of LH) and gonadotropin-releasing hormone agonists (Zoladex 3.6 mg).Pronin S.M., Matsneva I.A., Novikova E.G.
Subjects and methods. The investigation covered 79 patients. The case histories of 37 patients with atypical hyperplasia and 42 with stage IA (T1aNxMo) endometrial cancer were analyzed. The patients’ mean age was 33 years. The investigation was conducted at the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation.
Results. Primary treatment was completed in 67 (84.8%) patients and in 12 (15.2%) during hormonal treatment. After completion of special treatment, 8 (11.9%) of the 67 women had 10 pregnancies that resulted in childbirth and spontaneous miscarriage in 8 and 2 cases, respectively. Recurrences and incurable disease were stated in 3 (4.2%) and 9 (12.8%) cases, respectively. Repeated hormone therapy cycles were not performed because the patients had refused organ-sparing treatment. All the 12 (17.1%) patients were successfully operated on.
Conclusion. The proposed treatment regimen is a highly effective medical treatment in patients with precancer and early endometrial cancer. Independent hormone therapy is undoubtedly the best alternative to hysterectomy today in this group of patients who want to preserve reproductive function.
Keywords
endometrial cancer
atypical endometrial hyperplasia
organ-sparing treatment
pregnancy
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Received 20.03.2018
Accepted 20.04.2018
About the Authors
Pronin, Stanislav M., MD, Oncologist, Obstetrician-Gynecologist, Senior Researcher, Department of Innovative Oncology and Gynecology, National Medical Research Center of Obstetrics, Gynecology, and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4Matsneva, Irina A., a 5th year student of FSAEI of I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia.
119146, Russia, Moscow, Bolshaya Pirogovskaya str. 19, bld. 1
Novikova, Elena G., MD, professor, head of the gynecological department of tumors of the reproductive and urinary organs of P.A. Herzen Moscow Research Institute
of Oncology – a branch of the Scientific Medical Research Radiological Center, Ministry of Health of Russia.
125284, Russia, Moscow, 2nd Botkinsky Proezd, 3. E-mail egnov@bk.ru
For citations: Pronin S.M., Matsneva I.A., Novikova E.G. Possibilities of reproduction after treatment for early endometrial cancer. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (10): 100-4. (in Russian)
https://dx.doi.org/10.18565/aig.2018.10.100-104
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