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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

ARTEAGA-GOMEZ, Ana Cristina et al. Oncological and perinatal results of conservative treatment of fertility in patients with endometrial cancer treated with progestins. Ginecol. obstet. Méx. [online]. 2019, vol.87, n.2, pp.100-109.  Epub Mar 25, 2021. ISSN 0300-9041.  https://doi.org/10.24245/gom.v87i2.2511.

OBJECTIVE:

To estimate the complete response rate and pregnancy in women with endometrial cancer who have received conservative treatment with progestins.

MATERIALS AND METHODS:

Cohort, retrolective and transversal study carried out in the National Institute of Perinatology, in women with endometrial cancer in early stages between 2007 and December 2016. Including patients between 18-40 years, nulliparous, with desire for fertility. The progestins used were megestrol, IUD-levonorgestrel and micronized progesterone for six months. Endometrial biopsy was performed at 6 and 12 months; The result was classified as a complete, partial response, persistence or progression of the disease. Descriptive statistics and comparisons between baseline measurements at six and 12 months are used using student grid and / or t tests according to the distribution of each variable. It is a statistical program SPSS version 23 for Windows (Chicago, USA).

RESULTS:

11 women with endometrial cancer were included. The average age of the women was 32 ± 2.4 years. Morbidity associated with hypothyroidism and type 2 diabetes mellitus. Six-month biopsy was: complete response 6/11 partial response 2/11 and persistence 2/11, in one patient the biopsy was not performed at 6 months by pregnancy, there were no cases of progression. At 12 months of follow-up, there were 5 complete responses, 2 partial responses, 2 persistences, 1 case of disease progression and one case that discontinued treatment. Eight cycles of IVF were performed in 6 patients with a pregnancy rate of 25%, the duration of treatment was 19.3 ± 8 months, the total follow-up was 31.6 ± 13 months.

CONCLUSIONS:

Conservative fertility therapy with progestins in women younger than 40 years old with early-stage endometrial cancer is feasible and secure in our institution. Pregnancy must be sought immediately after a full response to the cancer treatment. Our findings are similar to the ones found in our systematic review of the international bibliography.

Keywords : Pregnancy; Endometrial cancer; Conservative treatment; Progestins; Megestrol; IUD-levonorgestrel or micronized progesterone, pregnancy rate; Endometrial biopsy.

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