Updates on conservative management of endometrial cancer in patients younger than 45 years

Practical issues and research trends of oncofertility in gynecologic cancer

“…For endometrial cancer, fertility-sparing treatment primarily consists of hormone therapy [19,20]. Among the various types of hormone therapies, the most widely used and researched is treatment using progestin [19,20].…”

“…For endometrial cancer, fertility-sparing treatment primarily consists of hormone therapy [19,20]. Among the various types of hormone therapies, the most widely used and researched is treatment using progestin [19,20]. High-dose oral progestin such as medroxyprogesterone acetate and megestrol acetate or a progestin-releasing intrauterine device are the most common methods for administering progestin [19,20].…”

“…Among the various types of hormone therapies, the most widely used and researched is treatment using progestin [19,20]. High-dose oral progestin such as medroxyprogesterone acetate and megestrol acetate or a progestin-releasing intrauterine device are the most common methods for administering progestin [19,20]. The widely accepted criteria for potential patients of fertility-sparing treatment in endometrial cancer are as follows: (1) the patient is a young woman who eagerly wants to preserve fertility; (2) the patient has stage I endometrial cancer confined to the endometrium; (3) endometrioid adenocarcinoma is present; and (4) the patient shows no prior evidence of infertility [21].…”

“…The pregnancy outcomes after fertility-sparing treatment using progestin are promising [24]. Recent studies have examined a treatment strategy in which all endometrial cancer tissues are removed via hysteroscopic surgery and adjuvant hormone therapy is administered [19,25]. In addition, studies have examined the therapeutic effects of metformin, aromatase inhibitors, gonadotropin-releasing hormone agonists, and several drug combinations [26].…”

Fertility-sparing management of early-stage endometrial cancer in reproductive age women: current treatment outcomes and future directions

“…The need for fertility-sparing treatment options for endometrial cancer is internationally recognized as an urgent priority to support women who wish to maintain their capability of carrying a pregnancy. 1 In this December 2021 lead article of the International Journal of Gynecological Cancer, Chae-Kim et al 2 present an overview of current evidence on outcomes of reproductive age women treated with progestin and metformin for atypical endometrial hyperplasia and early-stage endometrial cancer. Treatment with progestin and metformin was associated with lower rates of disease relapse compared with progestin alone.…”