Combined medroxyprogesterone acetate/levonorgestrel–intrauterine system treatment in young women with early-stage endometrial cancer

Kim, Mi Kyoung; Seong, Seok Ju; Kim, You Shin; Song, Taejong; Yoon, Bo Sung; Jun, Hey Jung; Lee, Yoon Hee

doi:10.1016/j.ajog.2013.06.031

Cited by 79 publications

(55 citation statements)

References 16 publications

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“…According to a recent review, 17 of 37 patients with stage IA (without myometrial invasion), grade 1 endometrial cancer achieved a complete response with a progestin-containing intrauterine device with a pooled complete response rate of 46% (95% confidence interval, 29%-63%) [78], which is a somewhat disappointing outcome. Hence, some investigators have reported the outcomes of a combined use of progestincontaining intrauterine device with oral progestin [18] or gonadotropin-releasing hormone agonist [17] for fertilitysparing therapy to achieve better outcomes than either agent alone. Kim et al [18] conducted a prospective observational study of 16 patients with stage IA (confined to endometrium), grade 1 endometrial cancer who were treated with progestincontaining intrauterine device with oral progestin.…”

Section: Oncologic Outcomes After Progestin Therapymentioning

confidence: 99%

“…Hence, some investigators have reported the outcomes of a combined use of progestincontaining intrauterine device with oral progestin [18] or gonadotropin-releasing hormone agonist [17] for fertilitysparing therapy to achieve better outcomes than either agent alone. Kim et al [18] conducted a prospective observational study of 16 patients with stage IA (confined to endometrium), grade 1 endometrial cancer who were treated with progestincontaining intrauterine device with oral progestin. The results of that study were promising because 14 patients (87%) achieved complete response, and only 2 patients (14.3%) had recurrent disease [18].…”

Section: Oncologic Outcomes After Progestin Therapymentioning

confidence: 99%

“…Kim et al [18] conducted a prospective observational study of 16 patients with stage IA (confined to endometrium), grade 1 endometrial cancer who were treated with progestincontaining intrauterine device with oral progestin. The results of that study were promising because 14 patients (87%) achieved complete response, and only 2 patients (14.3%) had recurrent disease [18]. Further evaluations are warranted in this regard.…”

Section: Oncologic Outcomes After Progestin Therapymentioning

confidence: 99%

“…Current fertility-sparing treatment modalities mainly comprise hormonal therapies involving progestins [12][13][14][15][16], progestin-releasing intrauterine devices [17][18][19][20][21], natural progesterone [22], oral contraceptives [23], selective estrogen receptor modulators [24][25][26],gonadotropin-releasing hormone agonist [24,27], and aromatase inhibitors [28]. Of these treatments, progestin therapy is the most commonly used, and its efficacy is well-known compared with other treatment modalities.…”

Section: Introductionmentioning

confidence: 99%

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Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Nam

2015

The Oncologist

109

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Endometrial cancer is the most common gynecologic cancer in developed countries. Approximately 3%-14% of endometrial cancers are diagnosed in young women under 40 who want to preserve their fertility. The incidence of endometrial cancer in this age group is increasing, for which fertility-sparing therapy is increasingly used because it is one of the most important quality of life issues in these women. Progestin therapy is the most common type of fertility-sparing therapy. In this review, the most up-to-date findings regarding fertility-sparing progestin therapy for young women with primary and recurrent endometrial cancer is addressed in terms of diagnosis, treatment, follow-up, and oncologic and reproductive outcomes. Fertility-sparing progestin therapy is highly effective in selected young women with primary and recurrent endometrial cancer. The selection of appropriate patients through comprehensive pretreatment evaluation is of paramount importance to achieve the best outcomes without compromising survival. Because of the high rate of recurrence after successful fertility-sparing therapy, close surveillance is mandatory, and prophylactic hysterectomy is the best option for patients who have completed family planning. Pregnancy outcomes are very promising with the aid of assisted reproductive technologies. Continuous daily oral medroxyprogesterone acetate and megestrol acetate are the preferred progestins for fertility-sparing therapy, but future studies should be performed to determine the optimal dose and treatment duration of these agents. The Oncologist 2015; 20:270-278 Implications for Practice: In young women with endometrial cancer, the cure rate is very high.Therefore, the efficacy of treatment should not be limited to the oncologic outcomes.The quality-of-life issue is as important as oncologic outcomes in these patients. Fertility preservation is one of the most important quality-of-life issues. Based on the results of numerous studies, fertility-sparing progestin therapy can be safely performed in endometrioid adenocarcinoma confined to the endometrium. It also can be reasonably recommended to selected women with more advanced disease and recurrent disease. However, careful follow-up is important because of the high rate of recurrence.

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Section: Oncologic Outcomes After Progestin Therapymentioning

confidence: 99%

Section: Oncologic Outcomes After Progestin Therapymentioning

confidence: 99%

Section: Oncologic Outcomes After Progestin Therapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Nam

2015

The Oncologist

109

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“…Xu et al [8] indicated that high concentrations of LNG suppressed the proliferation of uterine leiomyoma cells and promoted cell apoptosis. Furthermore, preliminary clinical studies suggest the LNG-IUS as a means of reducing endometrial pathology associated with tamoxifen patients with endometrial carcinoma [9].…”

Section: Introductionmentioning

confidence: 99%

Morphological and Ultrastructural Changes in Human Endometrium Following Low-Dose Levonorgestrel Contraceptive Intrauterine Systems (LNG-IUS-12) 13.5 mg

Chai

Dong

2014

J Obstet Gynecol India

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Pediatric, adolescent, and young adult breast and reproductive tumors

Harris

Rowell

Jayasinghe

et al. 2022

Pediatric Blood & Cancer

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Tumors of the breast and reproductive organs that occur in children, adolescents, and young adults (AYA) have different biological features and can present special challenges. Although prognosis for these tumors is generally favorable, the long‐term effects of treatment can be debilitating. Treatments are often multimodal and may include surgery as well as chemotherapy and/or radiation, which can cause considerable distress and anxiety related to loss of femininity or masculinity, concern over future fertility, or sexual dysfunction. Thus, tumors of the reproductive organs in pediatric/AYA patients require special consideration of the treatment effects beyond the intended oncologic outcome. Multidisciplinary teams should be involved in their care and address issues of fertility, sexual dysfunction, and psychosexual concerns before treatment begins. This review addresses histology, risk factors, prognosis, staging and treatment of gynecologic, breast and testicular cancers in pediatric and AYA patients.

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Combined medroxyprogesterone acetate/levonorgestrel–intrauterine system treatment in young women with early-stage endometrial cancer

Cited by 79 publications

References 16 publications

Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Progestins in the Fertility-Sparing Treatment and Retreatment of Patients With Primary and Recurrent Endometrial Cancer

Morphological and Ultrastructural Changes in Human Endometrium Following Low-Dose Levonorgestrel Contraceptive Intrauterine Systems (LNG-IUS-12) 13.5 mg

Pediatric, adolescent, and young adult breast and reproductive tumors

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