Oncologic and reproductive outcomes after fertility-sparing management with oral progestin for women with complex endometrial hyperplasia and endometrial cancer
Oncologic and reproductive outcomes after fertility-sparing management with oral progestin for women with complex endometrial hyperplasia and endometrial cancer
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DOI：
10.1016/j.ijgo.2015.06.046
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发表时间：
2016-01-01
影响因子：
3.8
通讯作者：
Pan, Lingya
中科院分区：
文献类型：
--
作者：
Chen, Ming;Jin, Ying;Pan, Lingya
目的：目的：探讨经曲马多治疗复杂性子宫内膜增生症（CEH）和I级子宫内膜癌（EC）后的肿瘤学和生殖结局。研究方法：在一项回顾性研究中，获得了2000年1月1日至2011年12月31日期间在中国北京协和医院接受治疗的年龄为20-42岁的CEH或1级EC患者的数据，这些患者处于假定的IA期（无子宫肌层浸润），希望保留生育能力。患者口服醋酸甲羟孕酮（250-500 mg/天）或醋酸甲地孕酮（160-480 mg/天）至少6个月。组织学上评估了对白蛋白治疗的反应。结果：在53例患者中，39例（74%）在中位6（3-24）个月后达到完全缓解。肥胖患者的完全缓解率低于非肥胖患者（4/12 [33%] vs 35/41 [85%]; P = 0.001）。10例（26%）完全缓解患者记录了疾病复发; 5年无复发生存率为71%。在33名保留怀孕愿望的患者中，17名（52%）怀孕。结论：口服雷公藤多甙保留生育能力是有效的。肥胖与长期成功的可能性较低有关。(C)2015年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To investigate the oncologic and reproductive outcomes after progestin treatment of complex endometrial hyperplasia (CEH) and grade I endometrial carcinoma (EC). Methods: In a retrospective study, data were obtained for patients aged 20-42 years with CEH or grade 1 EC at presumed stage IA (without myometrial invasion) who wished to preserve fertility and were treated at the Peking Union Medical College Hospital, China, between January 1, 2000, and December 31, 2011. Patients had received oral medroxyprogesterone acetate (250-500 mg/day) or megestrol acetate (160-480 mg/day) for at least 6 months. Response to progestin treatment was assessed histologically. Results: Among 53 included patients, 39 (74%) achieved complete response after a median period of 6 (3-24) months. Complete response was less frequent among obese than nonobese patients (4/12 [33%] vs 35/41 [85%]; P = 0.001). Disease recurrence was recorded in 10 (26%) patients with complete response; the 5-year recurrence-free survival rate was 71%. Among the 33 patients who retained a desire to conceive, 17 (52%) became pregnant. Conclusion: Fertility-sparing management with oral progestin is effective. Obesity is associated with a lower probability of long-term success. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.