scholarly journals Weight Loss Improves Pregnancy and Livebirth Outcomes in Young Women with Early-Stage Endometrial Cancer and Atypical Hyperplasia

2021 ◽  
Vol Volume 13 ◽  
pp. 5711-5722
Author(s):  
Yanfang Zhang ◽  
Dan Li ◽  
Qi Yan ◽  
Xueru Song ◽  
Wenyan Tian ◽  
...  
Keyword(s):  
Weight Loss ◽  
Endometrial Cancer ◽  
Young Women ◽  
Early Stage ◽  
Atypical Hyperplasia ◽  
Early Stage Endometrial Cancer

scholarly journals Weight loss improve pregnancy and livebirth outcomes in young women with early-stage endometrial cancer and atypical hyperplasia:15 years’ experience

2021 ◽  
Author(s):  
yanfang zhang ◽  
Dan Li ◽  
Qi Yan ◽  
Jinghua Wang ◽  
fei Teng ◽  
...  
Keyword(s):  
Weight Loss ◽  
Endometrial Cancer ◽  
Live Birth ◽  
Birth Rate ◽  
Early Stage ◽  
Live Birth Rate ◽  
Atypical Hyperplasia ◽  
Fertility Sparing ◽  
Weight Loss Group ◽  
Early Stage Endometrial Cancer

Abstract Background: To evaluate the effects of body weight loss on pregnancy and livebirth outcomes in young women with early-stage endometrial cancer (EC) and atypical hyperplasia (AH) with fertility-sparing therapy. Thus, improve the management of this patient group.Method: Patients with AH (n=36) and well-differentiated EC (n=8, FIGO stage IA) who achieved complete regression after conservative treatment were included in this retrospective study. A weight loss group (n=25) and a non-weight loss group (n=19) were divided; while subgroup analysis according to body mass index and stratification analysis according to weight loss proportion were performed to investigate the effect of weight loss on pregnancy and livebirth outcomes. A univariate and multivariate logistic regression analysis were undertaken to analysis the factors associated with pregnancy.Results: The mean body weight and body mass index at pretreatment of progestin and initiation of fertility treatment was 70.63±12.03 and 67.08±8.18 kg, respectively, and 27.06±4.44 and 25.73±3.15 kg/m2, respectively. 25 patients (56.82%) had weight loss; the median weight loss amount is 5.00kg (1.00-34.50), median weigh loss proportion was 6.70% (1.00-36.00) during median time interval of 12months (5.00-97.00). An impressive favorable pregnancy rate (65.91%) and live birth rate (50.00%) were achieved. The pregnancy and livebirth rate were meaningfully higher in the weight loss group than the non-weight loss group (88.00% vs.36.84%,P=0.000; 64.00% vs.31.58%,P=0.033, respectively); weight loss≥5% significantly increased pregnancy and live birth rate in patients with BMI≥25. The risk ratios of weight loss≥5% in multivariate logistic analysis for pregnancy was 0.096(0.010, 0.907).Conclusions: Weight loss could have a positive effect on pregnancy rates and seem to be useful for improving live birth rates in overweight or obese women with early-stage endometrial cancer and atypical hyperplasia during/after fertility-sparing therapy. weight loss≥5% was protective factors of pregnancy in fertility-sparing patients with early-stage endometrial cancer and atypical hyperplasia.

Does hormonal therapy for fertility preservation affect the survival of young women with early-stage endometrial cancer?

Cancer ◽  
2016 ◽  
Vol 123 (9) ◽  
pp. 1545-1554 ◽  
Author(s):  
Zoë R. Greenwald ◽  
Lina N. Huang ◽  
Michel D. Wissing ◽  
Eduardo L. Franco ◽  
Walter H. Gotlieb
Keyword(s):  
Endometrial Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Hormonal Therapy ◽  
Early Stage ◽  
Early Stage Endometrial Cancer

The role of genetic and epigenetic changes in the development of atypical hyperplasia and early-stage endometrial cancer

2021 ◽  
Vol 5_2021 ◽  
pp. 48-54
Author(s):  
Gadzhieva L.T. Gadzhieva L ◽  
Pronin S.M. Pronin ◽  
Pavlovich S.V. Pavlovich S ◽  
Kiselev V.I. Kiselev V ◽  
◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Atypical Hyperplasia ◽  
Epigenetic Changes ◽  
Early Stage Endometrial Cancer

scholarly journals Baseline Serum HE4 But Not Tissue HE4 Expression Predicts Response to the Levonorgestrel-Releasing Intrauterine System in Atypical Hyperplasia and Early Stage Endometrial Cancer

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 276 ◽  
Author(s):  
Roya Behrouzi ◽  
Neil A. J. Ryan ◽  
Chloe E. Barr ◽  
Abigail E. Derbyshire ◽  
Y. Louise Wan ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Smoking Status ◽  
Histological Grade ◽  
Menopausal Status ◽  
Tissue Expression ◽  
Atypical Hyperplasia ◽  
Low Grade ◽  
Baseline Serum ◽  
Early Stage Endometrial Cancer

The levonorgestrel-releasing intrauterine system (LNG-IUS) is a conservative management option for atypical hyperplasia (AH) and low grade early stage endometrial cancer (EEC), but around 1 in 3 patients fail to respond to treatment. The aim of this study was to investigate if serum and/or tissue HE4 expression could predict response to LNG-IUS therapy. Patients with AH or presumed Stage I EEC had serum and endometrial samples taken at baseline and at 3-month intervals over 12 months post-insertion of LNG-IUS. 74 patients were recruited and baseline demographics recorded. Of 57 patients for whom response was histologically determinable, 39 (68%) were responders and 18 (32%) non-responders. Mean baseline serum HE4 was significantly lower in responders (62.1 ± 1.1 pM, 95% confidence interval (CI) 52.7–73.2), compared to non-responders (125.6 ± 1.3 pM, 95% CI 74.5–211.7, p = 0.014), including when considering age, BMI, menopausal status, smoking status, and histological grade as covariables (p = 0.005). Baseline tissue HE4 expression was not significantly different in responders compared to non-responders (p = 0.999). Responders showed a significant mean reduction (−9.8 ± 3.4%, 95% CI −16.7 to −2.8%, p = 0.008) in serum HE4 between baseline and 3 months (p = 0.008), whereas non-responders showed no significant change (p = 0.676). Neither responders nor non-responders showed a significant percentage change in serum HE4 from baseline beyond 3 months (p > 0.05). Change in serum HE4 between baseline and 3 and 6 months and tissue HE4 tissue expression between baseline and 3, 6, and 12 months was not significantly different in responders compared to non-responders (p > 0.05). This study suggests that baseline serum HE4, but not baseline tissue HE4 expression, is independently predictive of response to the LNG-IUS and could be used to guide management decisions.

scholarly journals Fertility preserving management of early endometrial cancer in a patient cohort at the department of women’s health at the university of Tuebingen

2021 ◽  
Author(s):  
Jürgen Andress ◽  
Jana Pasternak ◽  
Christina Walter ◽  
Stefan Kommoss ◽  
Bernhard Krämer ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Conservative Treatment ◽  
Early Stage ◽  
Therapeutic Option ◽  
Premenopausal Women ◽  
Daily Basis ◽  
Atypical Hyperplasia ◽  
Pathological Examination ◽  
Before And After ◽  
Early Stage Endometrial Cancer

Abstract Purpose To investigate the oncologic and reproductive outcome of a conservative treatment with progestin agents in early-stage grade 1 endometrial cancer (G1EC), grade 2 endometrial cancer (G2EC) or complex atypical hyperplasia (CAH) in young premenopausal women. Methods Women treated for early-stage endometrial cancer or atypical hyperplasia of the endometrium with a conservative therapy between 2006 and 2018 were enrolled in this retrospective analysis. Progestin agents were orally administered on a daily basis for 3 months for at least one cycle. Endometrial tissue was obtained by hysteroscopy and Dilatation & Curettage (D&C) being performed before and after end of treatment. Therapeutic response was assessed by pathological examination. Results A total of 14 patients were included. After treatment with progestin agents, 11 of these patients initially showed a complete or partial response. Three patients with early-stage endometrial cancer did not respond. Of the three patients with initially diagnosed atypical hyperplasia, none showed any remaining disease later. Of the eight patients with initially diagnosed endometrial cancer, who had responded to first treatment, three patients were re-diagnosed with endometrial cancer later. One patient with initial endometrial cancer became pregnant but aborted in the 10th week. Conclusion Due to its good efficacy, progestin agents offer a feasible therapeutic option in the fertility-preserving treatment of early-stage endometrial cancer in young premenopausal women. However, recurrence rate remains high. Therefore, a close follow-up is mandatory, also in responders. Patients should be informed of limitations and risks of conservative treatment. Yet after completion of family planning, hysterectomy should be performed.

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