Is levonorgestrel intrauterine system effective for treatment of early endometrial cancer? Report of four cases and review of the literature

Dhar, Kakali; NeedhiRajan, T.; Koslowski, Maureen J.; Woolas, Robert

doi:10.1016/j.ygyno.2004.10.031

Cited by 97 publications

(51 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They showed a mean CR rate of 73.3% (range 45-100%) [18,19,20]. Moreover, another study evaluated the utility of LNG-IUD for the treatment of 4 young EC-G1 patients with PR overexpression and found a CR rate of 25% [21]. Thus, tumor response to progesterone (any route) might depend on factors other than the PR status.…”

Section: Controversial Topicsmentioning

confidence: 99%

“…Synchronous ovarian cancer can be present in 11-29% of women younger than 45 years with EC [28,29] and can be diagnosed in G1-EC [21]. In a recently published series of 20 cases of AEH and 14 cases of G1-EC in young women who underwent uterus-sparing treatment, pretreatment laparoscopy was performed, and concomitant early-stage ovarian cancer was confirmed in 5 of them (14%).…”

Section: Controversial Topicsmentioning

confidence: 99%

See 1 more Smart Citation

Controversies of the Hormonal Conservative Treatment of Endometrial Cancer

Minig

Franchi

Bernabe

et al. 2013

Gynecol Obstet Invest

View full text Add to dashboard Cite

Background: Hysterectomy plus salpingo-oophorectomy represents the standard treatment for patients with well-differentiated endometrial cancer (EC) limited to the endometrium. It is estimated that over 5% of EC are diagnosed in nulliparous women aged 35-44 years. In addition, EC can affect obese women with diabetes, hypertension and other comorbidities increasing the surgical risk. Methods: This article reviews the English literature in PubMed regarding hormonal treatment of EC. Results: Use of hormonal therapies has resulted in complete remission in 60-70%; many of these women were able to achieve full-term pregnancies, and in case of contraindication to surgery, resection could be avoided. Several topics, however, such as patient selection, interobserver histologic evaluation, the type/duration of hormonal treatment, modality of evaluation before treatment and surveillance after treatment, which are still subject to controversy, are therefore discussed in this paper. Conclusion: Uterus-sparing treatment of well-differentiated EC limited to the endometrium is feasible and has acceptable efficacy in women with increased surgical risk or those who wish to preserve their fertility. Although the methods applied to determine disease extent beyond the endometrium are still unsatisfactory, patient selection is a crucial factor determining the outcome of treatment. However, women must be fully informed about the possibility of treatment failure and the necessity of a close follow-up after therapy.

show abstract

Section: Controversial Topicsmentioning

confidence: 99%

Section: Controversial Topicsmentioning

confidence: 99%

Controversies of the Hormonal Conservative Treatment of Endometrial Cancer

Minig

Franchi

Bernabe

et al. 2013

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…However, even endometrial protection against tamoxifen-stimulated endometrial changes by using LNG-IUS was demonstrated in several studies (Gardner et al 2000, Chan et al 2007, Kesim et al 2008). All in all, it can be concluded that LNG-IUS is a promising alternative to hysterectomy for the treatment of endometrial hyperplasia, although data are too sparse to recommend treatment of early endometrial cancer, and case reports are controversial (Parazzini et al 1994, Sturgeon et al 1997, Varila et al 2001, Giannopoulos et al 2004, Dhar et al 2005, Kresowik et al 2008.…”

Section: Risk Using Nonhormonal and Hormonal Intrauterine Devicesmentioning

confidence: 99%

Hormonal contraception and risk of endometrial cancer: a systematic review

Mueck¹,

Seeger²,

Rabe³

2010

Endocrine-Related Cancer

View full text Add to dashboard Cite

More than 15 case-control studies and at least four large cohort studies demonstrated a decrease in the risk of endometrial cancer of about 50% for ever use of combined oral contraceptives (COCs). In most of these studies, this protective effect persisted for more than 10-15-20 years after cessation of the COC. An increasing protective effect with longer duration of COC use has been found in most studies. The beneficial effect was independent of the composition of COC, i.e. dosage and type of progestogen, combined with ethinyl estradiol 30-50 mg/day. COCs with higher progestogen potency seem to be somewhat more effective. Nonhormonal uterine devices have also been found to be strongly protective; however, data on oral or injectable progestogen-only preparations (POPs) including the levonorgestrel-releasing intrauterine system (LNG-IUS) are still rare, but also suggest similar protective action. COCs, POPs, as well as LNG-IUS can effectively reduce endometrial hyperplasia but should only be used in exceptional cases in patients with or after endometrial cancer. In contrast to nonhormonal IUS, systemic side effects cannot be excluded with LNG-IUS, but they are certainly rare, as the main effect has decreased the endometrial estrogen response because of the high endometrial tissue levels of LNG.

show abstract

“…Instead of oral progestrones, GnRH analogs are also effective. Levonorgestrel intrauterine devices (LNG IUD) considering their local effect on the endometrium with less systemic side effects are also effective in treating early cancer endometrium [19,20]. Progestrones produce side effects including head ache, weight gain, thromboembolism, and depression.…”

Section: Endometrial Cancermentioning

confidence: 99%

Fertility Sparing Surgery in Gynecologic Cancer

Rema

Ahmed

2014

J Obstet Gynecol India

View full text Add to dashboard Cite

Fertility preservation is one of the major concerns of young patients diagnosed with gynecological cancer. With newer treatment regimens and better surgical techniques, survival rates after cancer treatment have improved, hence preservation of fertility has recently become an important issue in the treatment of gynecological cancers. Fertility sparing surgery may be an option for early-stage cervical cancer with the development of loop excision techniques and radical trachelectomy which allows a radical approach to cervix cancer at the same time preserving the uterus and thus fertility. Fertility preservation is possible in Stage 1 epithelial ovarian cancers, germ cell ovarian tumors, and borderline cancers. Hormonal therapy with progestin agents is effective in early endometrial cancer. In patients desiring future pregnancy, fertility sparing options must be explored before starting treatment for gynecologic cancers.

show abstract

Is levonorgestrel intrauterine system effective for treatment of early endometrial cancer? Report of four cases and review of the literature

Cited by 97 publications

References 9 publications

Controversies of the Hormonal Conservative Treatment of Endometrial Cancer

Controversies of the Hormonal Conservative Treatment of Endometrial Cancer

Hormonal contraception and risk of endometrial cancer: a systematic review

Fertility Sparing Surgery in Gynecologic Cancer

Contact Info

Product

Resources

About