Fertility-Sparing Treatment for Endometrial Cancer: Oncological and Obstetric Outcomes in Combined Therapies with Levonorgestrel Intrauterine Device.

Autor: Pino I; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy., Iacobone AD; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy.; Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy., Vidal Urbinati AM; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy., Di Giminiani M; Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Department of Biological and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy., Radice D; Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy., Guerrieri ME; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy., Preti EP; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy., Martella S; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy., Franchi D; Preventive Gynecology Unit, European Institute of Oncology IRCCS, 20141 Milan, Italy.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2022 Apr 26; Vol. 14 (9). Date of Electronic Publication: 2022 Apr 26.
DOI: 10.3390/cancers14092170
Abstrakt: Background: The prevalence of reaches up to 5% in women younger than 40 years. Therefore, the fertility preservation should be the goal of the clinical practice in women with desire of pregnancy and low-risk features. The aim of this study is to compare oncological and reproductive outcomes of different hormonal therapies in FST of EC.
Methods: A retrospective single-center study recruiting patients with presumed FIGO STAGE IA endometrioid G1 EC from 2005 to 2020 was performed. We assessed outcomes for three different therapeutic options: GnRHa + LNG-IUD vs. MA + LNG-IUD vs. MA + LNG-IUD + MET.
Results: In total, 75 patients were enrolled and followed up for a median of 45 months. Complete response (CR) was achieved in 75% of patients at 12 months. Although not statistically significant, we reported an increasing rate of CR from the regimen with GnRHa to the one with MA + MET (65% vs. 83%). We showed a statistically significant lower risk of recurrence in women treated with MA + LNG-IUD + MET, when compared to GnRHa + LNG-IUD regimen. The pregnancy rate was 74% and live birth rate was 42%, with no differences among regimens.
Conclusions: FST is a safe and effective option in women who desire to preserve fertility.
Databáze: MEDLINE
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