scholarly journals Fertility preserving management of early endometrial cancer in a patient cohort at the department of women’s health at the university of Tuebingen

2021 ◽  
Author(s):  
Jürgen Andress ◽  
Jana Pasternak ◽  
Christina Walter ◽  
Stefan Kommoss ◽  
Bernhard Krämer ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Conservative Treatment ◽  
Early Stage ◽  
Therapeutic Option ◽  
Premenopausal Women ◽  
Daily Basis ◽  
Atypical Hyperplasia ◽  
Pathological Examination ◽  
Before And After ◽  
Early Stage Endometrial Cancer

Abstract Purpose To investigate the oncologic and reproductive outcome of a conservative treatment with progestin agents in early-stage grade 1 endometrial cancer (G1EC), grade 2 endometrial cancer (G2EC) or complex atypical hyperplasia (CAH) in young premenopausal women. Methods Women treated for early-stage endometrial cancer or atypical hyperplasia of the endometrium with a conservative therapy between 2006 and 2018 were enrolled in this retrospective analysis. Progestin agents were orally administered on a daily basis for 3 months for at least one cycle. Endometrial tissue was obtained by hysteroscopy and Dilatation & Curettage (D&C) being performed before and after end of treatment. Therapeutic response was assessed by pathological examination. Results A total of 14 patients were included. After treatment with progestin agents, 11 of these patients initially showed a complete or partial response. Three patients with early-stage endometrial cancer did not respond. Of the three patients with initially diagnosed atypical hyperplasia, none showed any remaining disease later. Of the eight patients with initially diagnosed endometrial cancer, who had responded to first treatment, three patients were re-diagnosed with endometrial cancer later. One patient with initial endometrial cancer became pregnant but aborted in the 10th week. Conclusion Due to its good efficacy, progestin agents offer a feasible therapeutic option in the fertility-preserving treatment of early-stage endometrial cancer in young premenopausal women. However, recurrence rate remains high. Therefore, a close follow-up is mandatory, also in responders. Patients should be informed of limitations and risks of conservative treatment. Yet after completion of family planning, hysterectomy should be performed.

scholarly journals Therapy of Early Endometrial Cancer Fertility preserving Management of Early Endometrial Cancer in a Patient Cohort at the Department of Women's Health at the University of Tuebingen

2020 ◽  
Author(s):  
Jürgen Andress ◽  
Jana Pasternak ◽  
Martin Weiss ◽  
Christina Walter ◽  
Stefan Kommoss ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Family Planning ◽  
Conservative Treatment ◽  
Early Stage ◽  
Therapeutic Option ◽  
Premenopausal Women ◽  
Daily Basis ◽  
Atypical Hyperplasia ◽  
Pathological Examination ◽  
Early Stage Endometrial Cancer

Abstract Background:Endometrial cancer ranges among the most common gynecologic cancers worldwide. As the incidence of causing risk factors increases it is also becoming more prevalent in younger, premenopausal women who havent´ completed family planning yet. Our study aimed to investigate the oncologic and reproductive outcome of a conservative treatment with progestin agents in early stage grade 1 endometrial cancer (G1EC), grade 2 endometrial cancer (G2EC) or complex atypical hyperplasia (CAH) in young premenopausal women. Methods:Women treated for early stage endometrial cancer or atypical hyperplasia of the endometrium with a conservative therapy between 2006 and 2018 were enrolled in this retrospective analysis. Progestin agents were orally administered on a daily basis for 3 months for at least one cycle. Endometrial tissue was obtained by hysteroscopy and Dilatation & Curettage (D&C) being performed before and after end of treatment. Therapeutic response was assessed by pathological examination.Results:A total of 14 patients were included. After treatment with progestin agents, 11 of these patients initially showed a complete or partial response. Three patients with early stage endometrial cancer did not respond. Of the three patients with initially diagnosed atypical hyperplasia, none showed any remaining disease later. Of the 8 patients with initially diagnosed endometrial cancer, who had responded to first treatment, 3 patients were re-diagnosed with endometrial cancer later. One patient with initial endometrial cancer became pregnant but aborted in the 10th week. Conclusion:Due to its good efficacy progestin agents offer a feasible therapeutic option in the fertility preserving treatment of early stage endometrial cancer in young premenopausal women. However, recurrence rate remains high in early stage endometrial cancer. Therefore, a close follow-up is mandatory, also in responders. Patients should be informed of limitations and risks of conservative treatment. Yet after completion of family planning, hysterectomy should be performed.

Survival Impact of Ovarian Preservation on Women With Early-Stage Endometrial Cancer: A Systematic Review and Meta-analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Haifeng Gu ◽  
Jundong Li ◽  
Yangkui Gu ◽  
Hua Tu ◽  
Yun Zhou ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Meta Analysis ◽  
Grey Literature ◽  
Disease Free Survival ◽  
Premenopausal Women ◽  
Cochrane Library ◽  
Ovarian Preservation ◽  
Significant Difference ◽  
Early Stage Endometrial Cancer

ObjectiveThe aim of this article was to investigate the survival impact of ovarian preservation in surgically treated patients with early-stage endometrial cancer using a meta-analysis.MethodsMajor online databases, including PubMed, EMBASE, Web of Science, the Cochrane Library, as well as Grey Literature database, were searched to collect studies on the effects of ovarian preservation compared with bilateral salpingo-oophorectomy (BSO) for surgical treatment in endometrial cancer patients. The literature search was performed up to April 2016. The results were analyzed using RevMan 5.0 software and Stata/SE 12.0 software.ResultsTotally, 7 retrospective cohort studies including 1419 patients in ovarian preservation group and 15,826 patients in BSO group were enrolled. Meta-analysis showed that there was no significant difference in overall survival between the patients treated with ovarian preservation and BSO (hazards ratio [HR], 1.00; 95% confidence interval [CI], 0.72–1.39; P = 1.00). Similar result was achieved in the young and premenopausal women (HR, 0.99; 95% CI, 0.70–1.39; P = 0.39). Furthermore, the disease-free survival of patients whose ovaries were preserved was slightly compromised but with no statistical significance (HR, 1.49; 95% CI, 0.56–3.93; P = 0.42).ConclusionsOvarian preservation may be safe in patients with early-stage endometrial cancer, and it could be cautiously considered in treating young and premenopausal women because it is not associated with an adverse impact on the patients’ survival. Given the inherent limitations of the included studies, further well-designed randomized controlled trial are needed to confirm and update this analysis.

scholarly journals Weight Loss Improves Pregnancy and Livebirth Outcomes in Young Women with Early-Stage Endometrial Cancer and Atypical Hyperplasia

2021 ◽  
Vol Volume 13 ◽  
pp. 5711-5722
Author(s):  
Yanfang Zhang ◽  
Dan Li ◽  
Qi Yan ◽  
Xueru Song ◽  
Wenyan Tian ◽  
...  
Keyword(s):  
Weight Loss ◽  
Endometrial Cancer ◽  
Young Women ◽  
Early Stage ◽  
Atypical Hyperplasia ◽  
Early Stage Endometrial Cancer

The role of genetic and epigenetic changes in the development of atypical hyperplasia and early-stage endometrial cancer

2021 ◽  
Vol 5_2021 ◽  
pp. 48-54
Author(s):  
Gadzhieva L.T. Gadzhieva L ◽  
Pronin S.M. Pronin ◽  
Pavlovich S.V. Pavlovich S ◽  
Kiselev V.I. Kiselev V ◽  
◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Atypical Hyperplasia ◽  
Epigenetic Changes ◽  
Early Stage Endometrial Cancer

scholarly journals Baseline Serum HE4 But Not Tissue HE4 Expression Predicts Response to the Levonorgestrel-Releasing Intrauterine System in Atypical Hyperplasia and Early Stage Endometrial Cancer

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 276 ◽  
Author(s):  
Roya Behrouzi ◽  
Neil A. J. Ryan ◽  
Chloe E. Barr ◽  
Abigail E. Derbyshire ◽  
Y. Louise Wan ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Smoking Status ◽  
Histological Grade ◽  
Menopausal Status ◽  
Tissue Expression ◽  
Atypical Hyperplasia ◽  
Low Grade ◽  
Baseline Serum ◽  
Early Stage Endometrial Cancer

The levonorgestrel-releasing intrauterine system (LNG-IUS) is a conservative management option for atypical hyperplasia (AH) and low grade early stage endometrial cancer (EEC), but around 1 in 3 patients fail to respond to treatment. The aim of this study was to investigate if serum and/or tissue HE4 expression could predict response to LNG-IUS therapy. Patients with AH or presumed Stage I EEC had serum and endometrial samples taken at baseline and at 3-month intervals over 12 months post-insertion of LNG-IUS. 74 patients were recruited and baseline demographics recorded. Of 57 patients for whom response was histologically determinable, 39 (68%) were responders and 18 (32%) non-responders. Mean baseline serum HE4 was significantly lower in responders (62.1 ± 1.1 pM, 95% confidence interval (CI) 52.7–73.2), compared to non-responders (125.6 ± 1.3 pM, 95% CI 74.5–211.7, p = 0.014), including when considering age, BMI, menopausal status, smoking status, and histological grade as covariables (p = 0.005). Baseline tissue HE4 expression was not significantly different in responders compared to non-responders (p = 0.999). Responders showed a significant mean reduction (−9.8 ± 3.4%, 95% CI −16.7 to −2.8%, p = 0.008) in serum HE4 between baseline and 3 months (p = 0.008), whereas non-responders showed no significant change (p = 0.676). Neither responders nor non-responders showed a significant percentage change in serum HE4 from baseline beyond 3 months (p > 0.05). Change in serum HE4 between baseline and 3 and 6 months and tissue HE4 tissue expression between baseline and 3, 6, and 12 months was not significantly different in responders compared to non-responders (p > 0.05). This study suggests that baseline serum HE4, but not baseline tissue HE4 expression, is independently predictive of response to the LNG-IUS and could be used to guide management decisions.

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