Prospective study of fertility‐sparing treatment with Chlormadinone acetate for endometrial carcinoma and atypical hyperplasia in young women

2021 ◽  
Author(s):  
Samia Ouasti ◽  
Margot Bucau ◽  
Elise Larouzee ◽  
Sebastien Clement De Givry ◽  
Nathalie Chabbert‐Buffet ◽  
...  
Keyword(s):  
Prospective Study ◽  
Endometrial Carcinoma ◽  
Young Women ◽  
Atypical Hyperplasia ◽  
Chlormadinone Acetate ◽  
Fertility Sparing

Controversies in the management of early endometrial carcinoma: an update

2017 ◽  
Vol 6 (6) ◽  
pp. 2124 ◽  
Author(s):  
P. Reddi Rani ◽  
Jasmina Begum ◽  
K. Sathyanarayana Reddy
Keyword(s):  
Developing Countries ◽  
Endometrial Carcinoma ◽  
Young Women ◽  
Genital Tract ◽  
Best Practice ◽  
Management Strategies ◽  
Evidence Based ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Cure Rates

Endometrial carcinoma (EC) is the commonest genital tract malignancy in developing countries and is usually confined to the uterus at the time of diagnosis with excellent prognosis and high cure rates. But the management is associated with lot of controversies like in staging, best surgical approach, extent of lymphadenectomy, adjuvant therapy, fertility sparing surgery in young women etc. A thorough surgical staging is important to determine uterine and extrauterine spread and also understanding of the pathophysiology and management strategies to identify women who are at high risk and tailoring the adjuvant treatment if necessary without increasing the morbidity. This evidence based narrative review conducted by searching Medline (1994- 2015) and other online articles from Pubmed, Google scholar. Articles were selected based on their currency and relevance to the discussion they summarize the current literature to provide an approach to best practice management of early endometrial carcinoma.

scholarly journals Comparison among fertility-sparing therapies for well differentiated early-stage endometrial carcinoma and complex atypical hyperplasia

Oncotarget ◽  
2017 ◽  
Vol 8 (34) ◽  
pp. 57642-57653 ◽  
Author(s):  
Qing Zhang ◽  
Gonghua Qi ◽  
Margaux J. Kanis ◽  
Ruifen Dong ◽  
Baoxia Cui ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Early Stage ◽  
Atypical Hyperplasia ◽  
Fertility Sparing ◽  
Well Differentiated

Predictability of later developed relapse in endometrial carcinoma in young women with functional imaging parameters of fes/FDG SUV ratio after fertility-sparing hormone treatment.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16502-e16502
Author(s):  
Yoshio Yoshida ◽  
Hidehiko Okazawa ◽  
Akiko Shinagawa ◽  
Yasushi Kiyono ◽  
Tetsuya Mori ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Young Women ◽  
Young Patients ◽  
Complete Response ◽  
Hormone Treatment ◽  
Tracer Uptake ◽  
High Dose ◽  
Standardized Uptake Values ◽  
Fertility Sparing ◽  
Significant Difference

e16502 Background: Even in responders of fertility-sparing hormone treatment for uterine endometrial carcinoma (EC) and atypical endometrial hyperplasia (AH) in young women, there have been high potential risks of later developed relapse. The aim of this study was whether changes in FDG and fluoroestradiol (FES) PET parameters following hormone treatment have the prognostic factor in prediction of later developed relapse. Methods: Eight young patients with EC and AH were treated by fertility-sparing treatment with a high-dose of medroxyprogesterone acetate (MPA) for 26 weeks. All patients underwent two FDG and FES-PET scans at baseline and 8 weeks after the beginning of MPA treatment, respectively. For each lesion, metabolic indices were calculated by standardized uptake values (SUV). All patients were followed up for 2 years. Values of FDG-SUV, FES-SUV and FES/FDG SUV ratio of tumors were retrospectively reviewed. The correlation between these parameters and clinical outcome of EC and AH for 2 years was evaluated. Results: An initial complete response was achieved in all patients. Two of 5 responders (40%) with AH and one of three (33%) responders with EC later developed (72-88weeks) relapse. One of those three patients underwent hysterectomy due to no response for additional MPA therapy. The tracer uptake of FDG and FES was decrease in all eight patients after 8 weeks. The FES/FDG ratio was increased in all three patients with later developed relapse, but the FES/FDG ratio was decrease in all patients without recurrence for 8 weeks. There was a significant difference of the change in FES/FDG ratio between later developed relapse patients and no relapse patients (0.113 vs -0.392; p = 0.044). Conclusions: This study suggests that an increase in the FES/FDG ratio after 8 weeks fertility-sparing hormone treatment with a high-dose of MPA may be a useful biomarker for predicting later developed relapse in EC and AH in young women.

Multicenter Phase II Study of Fertility-Sparing Treatment With Medroxyprogesterone Acetate for Endometrial Carcinoma and Atypical Hyperplasia in Young Women

2007 ◽  
Vol 25 (19) ◽  
pp. 2798-2803 ◽  
Author(s):  
Kimio Ushijima ◽  
Hideaki Yahata ◽  
Hiroyuki Yoshikawa ◽  
Ikuo Konishi ◽  
Toshiharu Yasugi ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Young Women ◽  
Medroxyprogesterone Acetate ◽  
Prospective Trial ◽  
Pathologic Complete Response ◽  
Fertility Treatment ◽  
High Dose ◽  
Fertility Sparing ◽  
Grade 3

Purpose To assess the efficacy of fertility-sparing treatment using medroxyprogesterone acetate (MPA) for endometrial carcinoma (EC) and atypical endometrial hyperplasia (AH) in young women. Patients and Methods This multicenter prospective study was carried out at 16 institutions in Japan. Twenty-eight patients having EC at presumed stage IA and 17 patients with AH at younger than 40 years of age were enrolled. All patients were given a daily oral dose of 600 mg of MPA with low-dose aspirin. This treatment continued for 26 weeks, as long as the patients responded. Histologic change of endometrial tissue was assessed at 8 and 16 weeks of treatment. Either estrogen-progestin therapy or fertility treatment was provided for the responders after MPA therapy. The primary end point was a pathologic complete response (CR) rate. Toxicity, pregnancy rate, and progression-free interval were secondary end points. Results CR was found in 55% of EC cases and 82% of AH cases. The overall CR rate was 67%. Neither therapeutic death nor irreversible toxicities were observed; however, two patients had grade 3 body weight gain, and one patient had grade 3 liver dysfunction. During the 3-year follow-up period, 12 pregnancies and seven normal deliveries were achieved after MPA therapy. Fourteen recurrences were found in 30 patients (47%) between 7 and 36 months. Conclusion The efficacy of fertility-sparing treatment with a high-dose of MPA for EC and AH was proven by this prospective trial. Even in responders, however, close follow-up is required because of the substantial rate of recurrence.

scholarly journals Frequency and characteristics of endometrial carcinoma and atypical hyperplasia detected on routine infertility investigations in young women: a report of six cases

2009 ◽  
Vol 24 (5) ◽  
pp. 1045-1050 ◽  
Author(s):  
H. Fujiwara ◽  
S. Ogawa ◽  
M. Motoyama ◽  
Y. Takei ◽  
S. Machida ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Young Women ◽  
Atypical Hyperplasia
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