Conservative hysteroscopic treatment of stage I well differentiated endometrial cancer in patients with high surgical risk: a pilot study
Conservative hysteroscopic treatment of stage I well differentiated endometrial cancer in patients with high surgical risk: a pilot study
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DOI：
10.3802/jgo.2019.30.e62
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发表时间：
2019-07-01
影响因子：
3.9
通讯作者：
Seracchioli, Renato
中科院分区：
文献类型：
--
作者：
Casadio, Paolo;Guasina, Francesca;Seracchioli, Renato
目的：目的：探讨宫腔镜联合左炔诺孕酮宫内节育器（LNG-IUD）治疗早期高分化子宫内膜癌（EC）的临床疗效。方法：对9例诊断为IA期、1级子宫内膜样癌（EC）且禁忌或拒绝接受标准外照射治疗的患者进行前瞻性研究。行宫腔镜下全宫切除术，放置LNG-IUD 5年。反应率，围手术期并发症，和疾病复发evaluated.Results：没有术中或术后并发症，所有出院不迟于住院的第三天。手术6个月后，所有女性的病变都完全消退。所有患者均完成了5年随访，无一例复发。两名妇女死亡的原因无关的肿瘤或正在进行的therapeutic.Conclusion：替代治疗与子宫内膜肌层宫腔镜切除术和LNG-IUD的妇女IA期，1级类子宫内膜样癌显示出初步令人鼓舞的结果，在有效性和安全性。
Objective: To report hysteroscopic treatment combined with levonorgestrel-releasing intrauterine device (LNG-IUD) to treat women with early well differentiated endometrial cancer (EC) at high surgical risk.Methods: Nine women diagnosed with stage IA, grade 1 endometrioid EC which was contraindicated or refused standard treatment with external beam radiation therapy with or without brachytherapy were enrolled in our prospective study. Endo-myometrial hysteroscopic resection of the whole uterine cavity and the placement of LNG-IUD for 5 years was performed. Response rate, perioperative complications, and recurrence of disease were evaluated.Results: None had intra or post-operative complications and all were discharged no later than the third day of hospitalization. After 6 months from surgery, all the women showed a complete regression of the lesion. All the women completed the 5 years follow-up and in no case was detected sign of recurrence. Two women died for causes unrelated to the tumor or the ongoing therapy.Conclusion: The alternative treatment with endo-myometrial hysteroscopic resection and LNG-IUD in women with stage IA, grade 1 endometrioid EC showed initial encouraging outcomes in terms of effectiveness and safety.