Efficacy of Megestrol Acetate (Megace) in the Treatment of Patients With Early Endometrial Adenocarcinoma: Our Experiences With 21 Patients

Eftekhar, Zahra; Izadi-Mood, Narges; Yarandi, Þ Fariba; Shojaei, Hadi; Rezaei, Zahra; Mohagheghi, Saeedeh

doi:10.1111/igc.0b013e31819c5372

Cited by 65 publications

(45 citation statements)

References 14 publications

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“…16,[19][20][21][22]24,26,27 They suggest encouraging results, with remission rates as high as 75-85%. These clinical reports are summarised in Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…Review of all hormonal treatment 76% complete response after an average of 12 weeks 34% of these had a recurrence 24% no response Four published deaths of patients conservatively treated Eftekhar et al 27 …”

Section: (Literature Review)mentioning

confidence: 99%

“…4,[7][8][9] There have been few studies published regarding this treatment approach, and although there appears to be a theme of generally promising results, as yet there are no ª 2010 The Authors Journal compilation ª RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology large patient series following this form of treatment to support reliable guidelines. 4,[16][17][18][19][20][21][22][23][24][25][26][27] To provide some further perspective, we have evaluated the outcome of all patients recently exercising this non-surgical treatment option at two major tertiary, universityaffiliated hospitals. In particular, we examined the effect of treatment on their disease and their ability to become pregnant.…”

Section: Introductionmentioning

confidence: 99%

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Progestogen treatment options for early endometrial cancer

Cade¹,

Ma²,

Rm³

et al. 2010

BJOG

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Objective Premenopausal women with early endometrial cancer may wish to maintain their fertility, and for some patients nonsurgical treatment options may be attractive. We have examined our own experience with such patients, as there are limited published data so far to support clear guidelines in this area.Design Retrospective analysis of a case series.Setting Case series from a specialist gynaecological oncology unit in a major tertiary referral hospital.Sample Sixteen patients receiving progestogen therapy for stage-1 endometrial cancer.Methods We reviewed our experience of all patients receiving progestogen therapy for stage-1 endometrial cancer, and we particularly examined their cancer-free outcome and fertility potential.Main outcome measures Response to treatment, duration of response, and subsequent pregnancies.Results Of the 16 patients investigated, four received an oral progestogen, five received the levonorgestrel-releasing intrauterine system (Mirena), and seven received both forms of treatment. Ten patients (63%) responded to treatment, with a median time to response of 5.5 months. Six patients did not respond to treatment, but all were either early in treatment or opted for surgical management before the average time of response. No patient who responded had a later recurrence. The mean total follow-up time was 27 months (range 3-134 months), with no patient deaths. Three patients had successful pregnancies, with one patient having two children.Conclusions This form of treatment appears to be a realistic treatment option in selected patients in the closely supervised environment of a specialist gynaecological oncology unit.

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“…16,[19][20][21][22]24,26,27 They suggest encouraging results, with remission rates as high as 75-85%. These clinical reports are summarised in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Section: (Literature Review)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Progestogen treatment options for early endometrial cancer

Cade¹,

Ma²,

Rm³

et al. 2010

BJOG

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“…Based on numerous epidemiologic and experimental studies it has been speculated that unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions (Fryer et al, 2002;Eftekhar et al, 2009;Chao et al, 2013;Campagnoli et al, 2013;Acmaz et al, 2014). Anovulatory cycles are common at menarche and menopause and usually induce benign endometrial proliferation including disordered proliferative endometrium and simple endometrial hyperplasia without nuclear atypia.…”

Section: Introductionmentioning

confidence: 99%

Antiproliferative Effect of Metformin on the Endometrium - a Clinical Trial

Tabrizi¹,

Sayyah-Melli²,

Foroughi³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. The aim of this study was to evaluate the anti-estrogenic effect of metformin on endometrial histology in comparison with progesterone. Materials and Methods: A total of 43 patients who were referred to our center for abnormal uterine bleeding and had a histologic diagnosis were disordered proliferative endometrium or simple endometrial hyperplasia were included and randomly distributed in two groups treated with metformin (500mg Bid) or megestrol (40mg daily), respectively, for three months. After this period the patients were evaluated by another endometrial biopsy to assess the impact of the two drugs in restoring normal endometrial histology. Results: Our findings revealed that metformin could induce endometrial atrophy in 21 out of 22 patients (95.5%) while this positive response was achieved in only 13 out of 21 patients (61.9%) in the megstrol group. In addition two low grade endometrial carcinomas in the metformin group responded very well. Conclusions: We conclude that metformin could be used as an effective antiestrogenic agent in control of abnormal endometrial proliferative disorders.

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“…Many of epidemiologic and experimental studies have reported the role of unopposed estrogen in development of endometrial benign, premalignant, and malignant lesions and AUBs (21)(22)(23)(24)(25). Disordered proliferative endometrium could be the first level of the estrogen-driven endometrial changes.…”

Section: Discussionmentioning

confidence: 99%