Conservative surgical management of stage IA endometrial carcinoma for fertility preservation
Conservative surgical management of stage IA endometrial carcinoma for fertility preservation
复制标题
DOI：
10.1016/j.fertnstert.2008.12.009
复制
发表时间：
2010-03-01
影响因子：
6.7
通讯作者：
Scambia, Giovanni
中科院分区：
文献类型：
--
作者：
Mazzon, Ivan;Corrado, Giacomo;Scambia, Giovanni
设计：前瞻性研究。地点：天主教圣心大学妇科肿瘤科，内窥镜下妇科科，新奥瓦克劳迪亚，罗马，意大利。患者(S)：6名IA期年轻子宫内膜癌患者。干预(S)：采用三步保守性切除技术，每一步都以病理分析为特征：切除肿瘤(步骤I)，切除肿瘤邻近的子宫内膜(步骤2)主要预后指标(S)：IA期子宫内膜癌的治疗和妊娠。结果(S)：保守性手术是有效的，因为术后3、6、9和12个月的经阴道超声和诊断性宫腔镜检结果均为非典型性或恶性。此外，6例患者中有4例(66%)实现了生育。结论(S)：这种方法。根据手术后的密切随访，对于那些希望保留生育能力的IA期子宫内膜癌女性来说，这可能是一种新的治疗选择。(Fertil Steril(R)2010；93：1286-9。(C)2010年由美国生殖医学学会公布。)
Objective: To describe an innovative method to preserve fertility in young women with stage IA endometrial cancer with use of hysteroscopic resection followed by administration of 160 mg of megestrol acetate.Design: Prospective study.Setting: Division of Gynecologic Oncology, Catholic University of the Sacred Heart, and the Endoscopic Gynecologic Unit, Nuova Villa Claudia, Rome, Italy.Patient(s): Six Young patients with stage IA endometrial cancer.Intervention(s): Conservative resectoscopic treatment using a three-step technique in which each step is characterized by a pathologic analysis: the removal of the tumor (step I), the removal of the endometrium adjacent to the tumor (step 2), and the removal of the myometrium underlying the tumor (step 3).Main Outcome Measure(s): Therapy of stage IA endometrial cancer and pregnancy.Result(s): The conservative Surgery was effective because results of transvaginal ultrasound examination and diagnostic hysteroscopy with target biopsies at 3, 6 9, and 12 months after surgery were negative for atypia or malignancy. Moreover, four out of six patients (66%) achieved childbearing.Conclusion(s): This method. under a close postsurgical follow-up, might represent a novel therapeutic option for those women with stage IA endometrial cancer who wish to preserve fertility. (Fertil Steril (R) 2010;93:1286-9. (C) 2010 by American Society for Reproductive Medicine.)