Fertility-Preserving Treatment in Young Women With Grade 1 Presumed Stage IA Endometrial Adenocarcinoma

Fan, Zunpan; Li, Hui; Hu, Rui; Liu, Yuling; Liu, Xinyu; LiPing, Gu

doi:10.1097/igc.0000000000001164

Cited by 75 publications

(83 citation statements)

References 41 publications

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“…This pattern is confirmed by the recent publication of Fan et al (30) with a CR of 95.3%, a pregnancy rate of 47.8% and a recurrence rate of 14.1%. No serious toxic side-effects occurred barring liver dysfunction in one patient (5).…”

Section: Discussionsupporting

confidence: 77%

“…Kim et al (22) performed a prospective observational study with MPA and LNG-IUD as FST. Some studies reported a FST combining LNG-IUD and GnRH agonist or progestin therapy as described in a recent meta-analysis (30) wherein a CR, a pregnancy rate and a recurrence rate of 72.9, 56, and 11% were shown respectively among the studies which use this FST.…”

Section: Discussionmentioning

confidence: 99%

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Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

et al. 2018

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Objectives: To evaluate the efficacy and safety of gonadotropin-releasing hormone (GnRH) agonist after endometrial resection in women suffering early stage endometrial carcinoma (EC) and/or endometrial intra-epithelial neoplasia (EIN).Design: A retrospective review of clinical files between January 1999 and December 2016.Setting: University hospital.Patients: Eighteen women younger than 41 years with grade 1 endometrial carcinoma (G1EC) and/or Endometrial intra-epithelial neoplasia (EIN). Interventions: All patients received GnRH agonist for 3 months after an endometrial resection combined with a laparoscopy to exclude concomitant ovarian tumor and/or other extra-uterine disease. The patient underwent a follow-up of 3 months interval with endometrial sampling by hysteroscopy.Main Outcome Measure(s): The recurrence rate and the pregnancy rate after fertility sparing treatment.Results: We identified 9 patients with EIN (50%), 7 patients with G1EC (38.9%), 1 with combined histology (5.5%), and 1 with G2EC (5.5%). After a median follow-up of 40.7 months, 12 patients conserved their uterus (66.7%), and 8 (53.3%) patients were pregnant with a total of 14 pregnancies among those who tried to become pregnant. We observed a complete response rate in 12 patients (66.7%) but 3 of these patients relapsed (25%). We also found a stable disease in 6 patients (33.3%).Conclusions: Compared with other fertility sparing treatments, GnRH agonist after surgery is an effective fertility-sparing strategy for women with EIN and/or G1EC. We recommend hysterectomy once a family has been completed even if the literature does not clearly lead to radical surgery.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

et al. 2018

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“…In endometrial cancer, temporary hormonal management for patients with grade 1 and 2 endometrioid neoplasms without suspected myometrial invasion is an option 25,26 . In our survey, it is worth mentioning that 30.2% disagreed with this recommendation.…”

Section: Discussionmentioning

confidence: 90%

“…19,32 In endometrial cancer, temporary hormonal management for patients with grade 1 and 2 endometrioid neoplasms without suspected myometrial invasion is an option. 25,26…”

Section: Discussionmentioning

confidence: 99%

Alternative management for gynecological cancer care during the COVID‐2019 pandemic: A Latin American survey

Rodriguez

Fletcher

Heredia

et al. 2020

Intl J Gynecology & Obste

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Objective: To determine the acceptance rate of treatment alternatives for women with either preinvasive conditions or gynecologic cancers during the COVID-19 pandemic among Latin American gynecological cancer specialists. Methods: Twelve experts in gynecological cancer designed an electronic survey, according to recommendations from international societies, using an online platform. The survey included 22 questions on five topics: consultation care, preinvasive cervical pathology, and cervical, ovarian, and endometrial cancer. The questionnaire was distributed to 1052 specialists in 14 Latin American countries. A descriptive analysis was carried out using statistical software. Results: A total of 610 responses were received, for an overall response rate of 58.0%. Respondents favored offering teleconsultation as triage for post-cancer treatment follow-up (94.6%), neoadjuvant chemotherapy in advanced stage epithelial ovarian cancer (95.6%), and total hysterectomy with bilateral salpingo-oophorectomy and defining adjuvant treatment with histopathological features in early stage endometrial cancer (85.4%). Other questions showed agreement rates of over 64%, except for review of pathology results in person and use of upfront concurrent chemoradiation for early stage cervical cancer (disagreement 56.4% and 58.9%, respectively). Conclusion: Latin American specialists accepted some alternative management strategies for gynecological cancer care during the COVID-19 pandemic, which may reflect the region's particularities. The COVID-19 pandemic led Latin American specialists to accept alternative management strategies for gynecological cancer care, especially regarding surgical decisions.

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“…Although most patients with endometrial cancer are elderly, some are younger. Younger patients may be treated with fertility-preserving therapies instead of surgery (5,6). Therefore, an accurate assessment of whether or not these patients have residual tumors after curettage or fertility-preserving therapies is of great importance.…”

Section: Introductionmentioning

confidence: 99%

Preoperative evaluation of residual tumor in patients with endometrial carcinoma by using ¹⁸F-FDG PET/CT

Chen

Zhou

et al. 2020

J. Cancer

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Purpose: To evaluate the value of 18 F-FDG positron emission tomography (PET)/computed tomography (CT) for determining the presence of residual tumors after curettage in patients with endometrial cancer. Methods: Preoperative 18 F-FDG PET/CT was performed in 90 women with endometrial cancer. PET/CT parameters and clinical characteristics were compared between patients with and without residual tumors. The clinical characteristics of patients with residual tumors that showed low 18 F-FDG uptake were also analyzed. Results: Among the 90 patients, 86 had residual tumors. ROC analysis identified a lesion SUVmax value of 5.0 as the optimal cutoff value for predicting whether or not patients had a residual tumor. With the SUVmax cutoff of 5, the sensitivity, specificity, positive predictive value, and negative predictive values for residual tumor prediction were 87.2%, 100%, 100%, and 26.7%, respectively. Univariate analysis showed significant associations between the high PET group (SUVmax > 5) and low PET group (SUVmax ≤ 5), and histologic type (P = 0.043) and tumor size (P < 0.001) in patients with residual tumors. In patients with low-grade and clear cell carcinomas and a tumor size < 1.35 cm, the probability of being in the low-PET group was 47.6%. In such patients, major parts of the residual tumors showed low 18 F-FDG uptake, similar to that in patients with no residual tumors. Conclusion: SUVmax was the lone predictive value for the presence of residual tumors after curettage in patients with endometrial cancer. Lesion SUVmax greater than 5 suggested a high possibility of residual tumors. In patients with low-grade and clear cell carcinomas with tumor size < 1.35 cm, residual tumors may present low 18 F-FDG uptake, mimicking the metabolic phenotypes of patients without residual tumors.

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Fertility-Preserving Treatment in Young Women With Grade 1 Presumed Stage IA Endometrial Adenocarcinoma

Cited by 75 publications

References 41 publications

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Alternative management for gynecological cancer care during the COVID‐2019 pandemic: A Latin American survey

Preoperative evaluation of residual tumor in patients with endometrial carcinoma by using ¹⁸F-FDG PET/CT

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Fertility-Preserving Treatment in Young Women With Grade 1 Presumed Stage IA Endometrial Adenocarcinoma

Cited by 75 publications

References 41 publications

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Alternative management for gynecological cancer care during the COVID‐2019 pandemic: A Latin American survey

Preoperative evaluation of residual tumor in patients with endometrial carcinoma by using 18F-FDG PET/CT

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Product

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Preoperative evaluation of residual tumor in patients with endometrial carcinoma by using ¹⁸F-FDG PET/CT