Fertility-Sparing in Endometrial CancerTangjitgamol S.a · Manusirivithaya S.a · Hanprasertpong J.b
aGynecologic Oncology Unit, Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, and bGynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Because endometrial cancer (EMC) patients frequently present at an early stage of disease, most have favorable outcomes, thus their quality of life after treatment is as important a consideration as a cure of cancer. This issue is especially important when EMC is encountered in younger or reproductive ages when the afflicted woman has not achieved her fertility function. It is a complicated situation when a physician encounters a request or question from a woman with EMC or her family concerning whether she could conceive a child prior to a definite cancer treatment. Despite being an interesting issue, there are only a few studies with definite treatment guidelines or any evidence-based recommendations concerning conservative treatment for EMC. Thus, we undertook this study to explore various considerations regarding the criteria and caveats for the management of EMC women who desire to preserve their fertility function. An algorithm guideline for conservative fertility treatment for EMC is also presented.
© 2009 S. Karger AG, Basel
- Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ: Cancer statistics, 2008. CA Cancer J Clin 2008;58:71–96.
Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK (eds): SEER Cancer Statistics Review, 1975–2005, National Cancer Institute. Available at http://seer.cancer.gov/csr/1975_2005. Accessed September 9, 2008.
Creasman WT: Endometrial cancer: incidence, prognostic factors, diagnosis and treatment. Semin Oncol 1997;24:140–150.
- Menken J, Trussell J, Larsen U: Age and infertility. Science 1986;233:1389–1394.
Ostor AG, Adam R, Gutteridge BH, Fortune DW: Endometrial carcinoma in young women: Aust NZ J Obstet Gynaecol 1982;22:38–42.
- Wilkinson EJ, Friedrich EG Jr, Mattingly RF, Regali JA, Garancis JC: Turner’s syndrome with endometrial adenocarcinoma and stilbestrol therapy. Obstet Gynecol 1973;42:193–200.
- Farhi DC, Nosanchuk J, Silverberg SG: Endometrial adenocarcinoma in women under 25 years of age. Obstet Gynecol 1986;68:741–745.
- Jafari K, Javaheri G, Ruiz G: Endometrial adenocarcinoma and the Stein-Leventhal syndrome. Obstet Gynecol 1978;51:97–100.
- Gallup DG, Stock RJ: Adenocarcinoma of the endometrium in women 40 years of age or younger. Obstet Gynecol 1984;64:417–420.
- Sparac V, Ujević B, Ujević M, Pagon-Belina Z, Marton U: Successful pregnancy after hysteroscopic removal of grade I endometrial carcinoma in a young woman with Lynch syndrome. Int J Gynecol Cancer 2006;16(suppl 1):442–445.
- Yarali H, Bozdag G, Aksu T, Ayhan A: A successful pregnancy after intracytoplasmic sperm injection and embryo transfer in a patient with endometrial cancer who was treated conservatively. Fertil Steril 2004;81:214–216.
- Lowe MP, Bender D, Sood AK, Davis W, Syrop CH, Sorosky JI: Two successful pregnancies after conservative treatment of endometrial cancer and assisted reproduction. Fertil Steril 2002;77:188–189.
- Lowe MP, Cooper BC, Sood AK, Davis WA, Syrop CH, Sorosky JI: Implementation of assisted reproductive technologies following conservative management of FIGO grade I endometrial adenocarcinoma and/or complex hyperplasia with atypia. Gynecol Oncol 2003;91:569–572.
- Pinto AB, Gopal M, Herzog TJ, Pfeifer JD, Williams DB: Successful in vitro fertilization pregnancy after conservative management of endometrial cancer. Fertil Steril 2001;76:826–829.
- Ogawa S, Koike T, Shibahara H, Ohwada M, Suzuki M, Araki S, Sato I: Assisted reproductive technologies in conjunction with conservatively treated endometrial adenocarcinoma. A case report. Gynecol Obstet Invest 2001;51:214–216.
- Shibahara H, Shigeta M, Toji H, Wakimoto E, Adachi S, Ogasawara T, Takemura T, Koyama K: Successful pregnancy in an infertile patient with conservatively treated endometrial adenocarcinoma after transfer of embryos obtained by intracytoplasmic sperm injection. Hum Reprod 1999;14:1908–1911.
- Cormio G, Martino R, Loizzi V, Resta L, Selvaggi L: A rare case of choroidal metastasis presented after conservative management of endometrial cancer. Int J Gynecol Cancer 2006;16:2044–2048.
- Phelan C, Montag AG, Rotmensch J, Waggoner SE, Yamada SD, Mundt AJ: Outcome and management of pathological stage I endometrial carcinoma patients with involvement of the lower uterine segment. Gynecol Oncol 2001;85:513–517.
- Mayr NA, Wen BC, Benda JA, Sorosky JI, Davis CS, Fuller RW, Hussey DH: Postoperative radiation therapy in clinical stage I cancer: corpus, cervical and lower uterine segment involvement – patterns of failure. Radiology 1995;196:323–328.
- Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB: Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Group Study. Cancer 1987;60:2035–2041.
- Morrow CP, Bundy BN, Kurman RJ, Creasman WT, Heller P, Homesley HD, Graham JE: Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of endometrium: a Gynecologic Group Study. Gynecol Oncol 1991;40:55–65.
- DiSaia PJ, Creasman WT, Boronow RC, Blessing JA: Risk factors and recurrent patterns in stage I endometrial cancer. Am J Obstet Gynecol 1985;151:1009–1015.
- Vinker S, Shani A, Open M, Fenig E, Dgani R: Conservative treatment of adenocarcinoma of the endometrium in young patients. Is it appropriate? Eur J Obstet Gynecol Reprod Biol 1999;83:63–65.
- Imai M, Jobo T, Sato R, Kawaguchi M, Kuramoto H: Medroxyprogesterone acetate therapy for patients with adenocarcinoma of the endometrium who wish to preserve the uterus – usefulness and limitations. Eur J Gynaecol Oncol 2001;22:217–220.
- Boronow RC, Morrow CP, Creasman WT, Disaia PJ, Silverberg SG, Miller A, Blessing JA: Surgical staging in endometrial cancer: clinical-pathologic findings of a prospective study. Obstet Gynecol 1984;63:825–832.
- Lurain JR, Rice BL, Rademaker AW, Poggensee LE, Schink JC, Miller DS: Prognostic factors associated with recurrence in clinical stage I adenocarcinoma of the endometrium. Obstet Gynecol 1991;78:63–69.
- Liao BS, Twiggs LB, Leung BS, Yu WC, Potish RA, Prem KA: Cytoplasmic estrogen and progesterone receptors as prognostic parameters in primary endometrial carcinoma. Obstet Gynecol 1986;67:463–467.
- Creasman WT, Soper JT, McCarty KS Jr, McCarty KS Sr, Hinshaw W, Clarke-Pearson DL: Influence of cytoplasmic steroid receptor content on prognosis of early stage endometrial carcinoma. Am J Obstet Gynecol 1985;151:922–932.
- Thigpen JT, Brady MF, Alvarez RD, Adelson MD, Homesley HD, Manetta A, Soper JT, Given FT: Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. J Clin Oncol 1999;17:1736–1744.
Zuckerman B, Lavie O, Neumann M, Rabinowitz R, Ben-Chetrit A, Voss E, Rosenmann E, Beller U: Endometrial carcinoma stage I-grade II. Conservative treatment followed by a healthy twin pregnancy.Int J Gynecol Cancer1998;8:172–174.
- Gotlieb WH, Beiner ME, Shalmon B, Korach Y, Segal Y, Zmira N, Koupolovic J, Ben-Baruch G: Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer. Obstet Gynecol 2003;102:718–725.
- Sardi J, Anchezar Henry JP, Paniceres G, Gomez Rueda N, Vighi S: Primary hormonal treatment for early endometrial carcinoma. Eur J Gynaecol Oncol 1998;19:565–568.
- Kempson RL, Pokorny GE: Adenocarcinoma of the endometrium in women aged forty and younger. Cancer 1968;21:650–662.
- Bokhman JV, Chepick OF, Volkova AT, Vishnevsky AS: Can primary endometrial carcinoma stage I be cured without surgery and radiation therapy? Gynecol Oncol 1985;20:139–155.
- Kaku T, Yoshikawa H, Tsuda H, Sakamoto A, Fukunaga M, Kuwabara Y, Hataeg M, Kodama S, Kuzuya K, Sato S, Nishimura T, Hiura M, Nakano H, Iwasaka T, Miyazaki K, Kamura T: Conservative therapy for adenocarcinoma and atypical endometrial hyperplasia of the endometrium in young women: central pathologic review and treatment outcome. Cancer Lett 2001;167:39–48.
- Cohn DE, Horowitz NS, Mutch DG, Kim SM, Manolitsas T, Fowler JM: Should the presence of lymphvascular space involvement be used to assign patients to adjuvant therapy following hysterectomy for unstaged endometrial cancer? Gynecol Oncol 2002;87:243–246.
- Zaino RJ, Kurman RJ, Diana KL, Morrow CP: Pathologic models to predict outcome for women with endometrial adenocarcinoma: the importance of the distinction between surgical stage and clinical stage – a Gynecologic Oncology Group study. Cancer 1996;77:1115–1121.
- Homsley HD: Management of endometrial cancer. Am J Obstet Gynecol 1996;174:513–514.
- Takeshima N, Hirai Y, Yano K, Tanaka N, Yamauchi K, Hasumi K: Ovarian metastasis in endometrial carcinoma. Gynecol Oncol 1998;70:183–187.
- Walsh C, Holschneider C, Hoang Y, Tieu K, Karlan B, Cass I: Coexisting ovarian malignancy in young women with endometrial cancer. Obstet Gynecol 2005;106:693–699.
- Evans-Metcalf ER, Brooks SE, Reale FR, Baker SP: Profile of women 45 years of age and younger with endometrial cancer. Obstet Gynecol 1998;91:349–354.
- Gitsch G, Hanzal E, Jensen D, Hacker NF: Endometrial cancer in premenopausal women 45 years and younger. Obstet Gynecol 1995;85:504–508.
- Morice P, Fourchotte V, Sideris L, Gariel C, Duvillard P, Castaigne D: A need for laparoscopic evaluation of patients with endometrial carcinoma selected for conservative treatment. Gynecol Oncol 2005;96:245–248. Comment in Gynecol Oncol 2005;98:175; author’s reply: p 176.
- Yamazawa K, Hirai M, Fujito A, Nishi H, Terauchi F, Ishikura H, Shozu M, Isaka K: Fertility-preserving treatment with progestin, and pathological criteria to predict responses, in young women with endometrial cancer. Hum Reprod 2007;22:1953–1958.
- Shamshirsaz AA, Withiam-Leitch M, Odunsi K, Baker T, Frederick PJ, Lele S: Young patients with endometrial carcinoma selected for conservative treatment: a need for vigilance for synchronous ovarian carcinomas, case report and literature review. Gynecol Oncol 2007;104:757–760.
- Yang YC, Wu CC, Chen CP, Chang CL, Wang KL: Reevaluating the safety of fertility-sparing hormonal therapy for early endometrial cancer. Gynecol Oncol 2005;99:287–293.
- Huang SY, Jung SM, Ng KK, Chang YC, Lai CH: Ovarian metastasis in a nulliparous woman with endometrial adenocarcinoma failing conservative hormonal treatment. Gynecol Oncol 2005;97:652–655.
- Steiner E, Eicher O, Sagemüller J, Schmidt M, Pilch H, Tanner B, Hengstler JG, Hofmann M, Knapstein PG: Multivariate independent prognostic factors in endometrial carcinoma: a clinicopathologic study in 181 patients: 10 years experience at the Department of Obstetrics and Gynecology of the Mainz University. Int J Gynecol Cancer 2003;13:197–203.
- Takeshima N, Hirai Y, Tanaka N, Yamawaki T, Yamauchi K, Hasumi K: Pelvic lymph node metastasis in endometrial cancer with no myometrial invasion. Obstet Gynecol 1996;88:280–282.
- Eltabbakh GH, Shamonki J, Mount SL: Surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy shows well- differentiated tumors. Gynecol Oncol 2005;99:309–312.
- Nyholm HC, Nielsen AL, Lyndrup J, Norup P, Thorpe SM: Biochemical and immunohistochemical estrogen and progesterone receptors in adenomatous hyperplasia and endometrial carcinoma: correlations with stage and other clinicopathologic features. Am J Obstet Gynecol 1992;167:1334–1342.
- Zaino RJ, Davis AT, Ohlsson-Wilhelm BM, Brunetto VL: DNA content is an independent prognostic indicator in endometrial adenocarcinoma. A Gynecologic Oncology Group study. Int J Gynecol Pathol 1998;17:312–319.
- Susini T, Rapi S, Massi D, Savino L, Amunni G, Taddei GL, Massi G: Preoperative evaluation of tumor ploidy in endometrial carcinoma: an accurate tool to identify patients at risk for extrauterine disease and recurrence. Cancer 1999;86:1005–1012.
- Kung FT, Chen WJ, Chou HH, Ko SF, Chang SY: Conservative management of early endometrial adenocarcinoma with repeat curettage and hormone therapy under assistance of hysteroscopy and laparoscopy. Hum Reprod 1997;12:1649–1653.
- Dijkhuizen FP, Mol BW, Brölmann HA, Heintz AP: The accuracy of endometrial sampling in the diagnosis of patients with endometrial carcinoma and hyperplasia: a meta-analysis. Cancer 2000;89:1765–1772.
- Guido RS, Kanbour-Shakir A, Rulin MC, Christopherson WA: Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer. J Reprod Med 1995;40:553–555.
- Trimble CL, Kauderer J, Zaino R, Silverberg S, Lim PC, Burke JJ 2nd, Alberts D, Curtin J: Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer 2006;106:812–819.
- Larson DM, Johnson KK, Broste SK, Krawisz BR, Kresl JJ: Comparison of D&C and office endometrial biopsy in predicting final histopathologic grade in endometrial cancer. Obstet Gynecol 1995;86:38–42.
- Fujiwara H, Shibahara H, Usui R, Takamizawa S, Kosuge S, Ohwada M, Suzuki M, Sato I: Unsuspected uterine carcinosarcoma (heterologous) diagnosed following conservative therapies with medroxyprogesterone acetate for presumed early-stage endometrial carcinoma. Am J Reprod Immunol 2002;47:129–131.
- Jacques SM, Qureshi F, Munkarah A, Lawrence WD: Interinstitutional surgical pathology review in gynecologic oncology. II. Endometrial cancer in hysterectomy specimens. Int J Gynecol Pathol 1998;17:42–45.
- Garuti G, Mirra M, Luerti M: Hysteroscopic view in atypical endometrial hyperplasias: a correlation with pathologic findings on hysterectomy specimens. J Minim Invasive Gynecol 2006;13:325–330.
- Garuti G, De Giorgi O, Sambruni I, Cellani F, Luerti M: Prognostic significance of hysteroscopic imaging in endometrioid endometrial adenocarcinoma. Gynecol Oncol 2001;81:408–413.
- Mazzon I, Corrado G, Morricone D, Scambia G: Reproductive preservation for treatment of stage IA endometrial cancer in a young woman: hysteroscopic resection. Int J Gynecol Cancer 2005;15:974–978.
- Iha T, Shen H, Kanazawa K: Hysteroscopy to detect stage IA well-differentiated endometrioid adenocarcinoma of the endometrium. Acta Obstet Gynecol Scand 2003;82:378–384.
- Obermair A, Geramou M, Gucer F, Denison U, Graf AH, Kapshammer E, Neunteufel W, Frech I, Kaider A, Kainz C: Does hysteroscopy facilitate tumor cell dissemination? Incidence of peritoneal cytology from patients with early stage endometrial carcinoma following dilatation and curettage (D&C) versus hysteroscopy and D&C. Cancer 2000;88:139–143.
- Selvaggi L, Cormio G, Ceci O, Loverro G, Cazzolla A, Bettocchi S: Hysteroscopy does not increase the risk of microscopic extrauterine spread in endometrial carcinoma. Int J Gynecol Cancer 2003;13:223–227.
- Biewenga P, de Blok S, Birnie E: Does diagnostic hysteroscopy in patients with stage I endometrial carcinoma cause positive peritoneal washings? Gynecol Oncol 2004;93:194–198.
- Gu M, Shi W, Huang J, Barakat RR, Thaler HT, Saigo PE: Association between initial diagnostic procedure and hysteroscopy and abnormal peritoneal washings in patients with endometrial carcinoma. Cancer 2002;96:123–124.
- Obermair A, Geramou M, Gücer F, Denison U, Graf AH, Kapshammer E, Medl M, Rosen A, Wierrani F, Neunteufel W, Frech I, Preyer O, Speiser P, Kainz C: Impact of hysteroscopy on disease-free survival in clinically stage I endometrial cancer patients. Int J Gynecol Cancer 2000;10:275–279.
- Vilos GA, Edris F, Al-Mubarak A, Ettler HC, Hollett-Caines J, Abu-Rafea B: Hysteroscopic surgery does not adversely affect the long-term prognosis of women with endometrial adenocarcinoma. J Minim Invasive Gynecol 2007;14:205–210.
- Almog B, Gutman G, Lessing JB, Grisaru D: Prediction of cervical involvement in endometrial cancer by hysteroscopy. Arch Gynecol Obstet 2007;275:45–48.
- Nagar H, Dobbs S, McClelland HR, Price J, McCluggage WG, Grey A: The diagnostic accuracy of magnetic resonance imaging in detecting cervical involvement in endometrial cancer. Gynecol Oncol 2006;103:431–434.
- Leminen A, Forss M, Lehtovirta P: Endometrial adenocarcinoma with clinical evidence of cervical involvement: accuracy of diagnostic procedures, clinical course, and prognostic factors. Acta Obstet Gynecol Scand 1995;74:61–66.
- Toki T, Oka K, Nakayama K, Oguchi O, Fujii S: A comparative study of preoperative procedures to assess cervical invasion by endometrial carcinoma. Br J Obstet Gynaecol 1998;105:512–516.
- Sawicki W, Spiewankiewicz B, Stelmachów J, Cendrowski K: The value of ultrasonography in preoperative assessment of selected prognostic factors in endometrial cancer. Eur J Gynaecol Oncol 2003;24:293–298.
- DelMaschio A, Vanzulli A, Sironi S, Spagnolo D, Belloni C, Garancini P, Taccagni GL: Estimating the depth of myometrial involvement by endometrial carcinoma: efficacy of transvaginal sonography vs. MR imaging. AJR Am J Roentgenol 1993;160:533–538.
- Yamashita Y, Mizutani H, Torashima M, Takahashi M, Miyazaki K, Okamura H, Ushijima H, Ohtake H, Tokunaga T: Assessment of myometrial invasion by endometrial carcinoma: transvaginal sonography vs. contrast-enhanced MR imaging. AJR Am J Roentgenol 1993;161:595–599.
- Kinkel K, Kaji Y, Yu KK, Segal MR, Lu Y, Powell CB, Hricak H: Radiologic staging in patients with endometrial cancer: a meta-analysis. Radiology 1999;212:711–718.
- Frei KA, Kinkel K, Bonél HM, Lu Y, Zaloudek C, Hricak H: Prediction of deep myometrial invasion in patients with endometrial cancer: clinical utility of contrast-enhanced MR imaging – a meta-analysis and Bayesian analysis. Radiology 2000;216:444–449.
- Chung HH, Kang SB, Cho JY, Kim JW, Park NH, Song YS, Kim SH, Lee HP: Accuracy of MR imaging for the prediction of myometrial invasion of endometrial carcinoma. Gynecol Oncol 2007;104:654–659.
- Ben-Shachar I, Vitellas KM, Cohn DE: The role of MRI in the conservative management of endometrial cancer. Gynecol Oncol 2004;93:233–237.
- Scoutt LM, McCarthy SM, Flynn SD, Lange RC, Long F, Smith RC, Chambers SK, Kohorn E, Schwartz P, Chambers JT: Clinical stage I endometrial carcinoma: pitfalls in preoperative assessment with MR imaging. Work in progress. Radiology 1995;194:567–572.
- Scheidler J, Hricak H, Yu KK, Subak L, Segal MR: Radiological evaluation of lymph node metastases in patients with cervical cancer. A meta-analysis. JAMA 1997;278:1096–1101.
- Bipat S, Glas AS, van der Velden J, Zwinderman AH, Bossuyt PM, Stoker J: Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review. Gynecol Oncol 2003;91:59–66.
- Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, Grigsby PW, Siegel BA, Mutch DG: Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol 2004;95:546–551.
- Chao A, Chang TC, Ng KK, Hsueh S, Huang HJ, Chou HH, Tsai CS, Yen TC, Wu TI, Lai CH: 18F-FDG-PET in the management of endometrial cancer. Eur J Nucl Med Mol Imaging 2006;33:36–44.
- Park JY, Kim EN, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT, Nam JH: Comparison of the validity of magnetic resonance imaging and positron emission tomography/computed tomography in the preoperative evaluation of patients with uterine corpus cancer. Gynecol Oncol 2008;108:486–492.
- Nayot D, Kwon JS, Carey MS, Driedger A: Does preoperative positron emission tomography with computed tomography predict nodal status in endometrial cancer? A pilot study. Curr Oncol 2008;15:123–125.
- Yahata T, Fujita K, Aoki Y, Tanaka K: Long-term conservative therapy for endometrial adenocarcinoma in young women. Hum Reprod 2006;21:1070–1075.
- Park JC, Cho CH, Rhee JH: A successful live birth through in vitro fertilization program after conservative treatment of FIGO grade I endometrial cancer. J Korean Med Sci 2006;21:567–571.
- Randall TC, Kurman RJ: Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40. Obstet Gynecol 1997;90:434–440.
- Lai CH, Hsueh S, Chao AS, Soong YK: Successful pregnancy after tamoxifen and megestrol acetate therapy for endometrial carcinoma. Br J Obstet Gynaecol 1994;101:547–549.
- Wang CB, Wang CJ, Huang HJ, Hsueh S, Chou HH, Soong YK, Lai CH: Fertility-preserving treatment in young patients with endometrial adenocarcinoma. Cancer 2002;94:2192–2198.
- Ushijima K, Yahata H, Yoshikawa H, Konishi I, Yasugi T, Saito T, Nakanishi T, Sasaki H, Saji F, Iwasaka T, Hatae M, Kodama S, Saito T, Terakawa N, Yaegashi N, Hiura M, Sakamoto A, Tsuda H, Fukunaga M, Kamura T: Multicenter phase II study of fertility-sparing treatment with medroxyprogesterone acetate for endometrial carcinoma and atypical hyperplasia in young women. J Clin Oncol 2007;25:2798–2803.
- O’Neill RT: Pregnancy following hormonal therapy for adenocarcinoma of the endometrium. Am J Obstet Gynecol 1970;108:318 –321.
- Kim YB, Holschneider CH, Ghosh K, Nieberg RK, Montz FJ: Progestin alone as primary treatment of endometrial carcinoma in premenopausal women. Report of seven cases and review of the literature. Cancer 1997;79:320–327.
- Lee KR, Scully RE: Complex endometrial hyperplasia and carcinoma in adolescents and young women 15 to 20 years of age. A report of 10 cases. Int J Gynecol Pathol 1989;8:201–213.
- Montz FJ, Bristow RE, Bovicelli A, Tomacruz R, Kurman RJ: Intrauterine progesterone treatment of early endometrial cancer. Am J Obstet Gynecol 2002;186:651–657.
- Giannopoulos T, Butler-Manuel S, Tailor A: Levonorgestrel-releasing intrauterine system as a therapy for endometrial carcinoma. Gynecol Oncol 2004;95:762–764.
- Dhar KK, NeedhiRajan T, Koslowski M, Woolas RP: Is levonorgestrel intrauterine system effective for treatment of early endometrial cancer? Report of four cases and review of the literature. Gynecol Oncol 2005;97:924–927.
- Kothari R, Seamon L, Cohn D, Fowler J, O’Malley DM: Stage IV endometrial cancer after failed conservative management: a case report. Gynecol Oncol 2008;111:579–582.
- Schammel DP, Mittel KR, Kaplan K, Deligdisch L, Tavassoli FA: Endometrial adenocarcinoma associated with intrauterine pregnancy: a report of five cases and a review of the literature. Int J Gynecol Pathol 1998;17:327–335.
- Fechner RE, Kaufman RH: Endometrial adenocarcinoma in Stein-Leventhal syndrome. Cancer 1974;34:444–452.
- Chang WH, Chen CH, Yu MH: Conservative therapy of stage I endometrial adenocarcinoma and atypical endometrial hyperplasia for the preservation of fertility. Int J Gynaecol Obstet 2006;92:137–138.
- Demirol A, Bahce M, Ayhan A, Gurgan T: Pregnancy following intracytoplasmic sperm injection and preimplantation genetic diagnosis after the conservative management of endometrial cancer. Reprod Biomed Online 2005;10:770–773.
- Duska LR, Garrett A, Rueda BR, et al: Endometrial cancer in women 40 years old or younger. Gynecol Oncol 2001;83:388–393.
- Eddy WA: Endometrial carcinoma in Stein-Leventhal syndrome treated with hydroxyprogesterone caproate. Am J Obstet Gynecol 1978;131:581–582.
- Jobo T, Imai M, Kawaguchi M, Kenmochi M, Kuramoto H: Successful conservative treatment of endometrial carcinoma permitting subsequent pregnancy: report of two cases. Eur J Gynaecol Oncol 2000;21:119–122.
- Kimmig R, Strowitzki T, Müller-Höcker J, Kürzl R, Korell M, Hepp H: Conservative treatment of endometrial cancer permitting subsequent triplet pregnancy. Gynecol Oncol 1995;58:255–257.
- Nakao Y, Nomiyama M, Kojima K, Matsumoto Y, Yamasaki F, Iwasaka T: Successful pregnancies in 2 infertile patients with endometrial adenocarcinoma. Gynecol Obstet Invest 2004;58:68–71.
- Niwa K, Tagami K, Lian Z, Onogi K, Mori H, Tamaya T: Outcome of fertility-preserving treatment in young women with endometrial carcinomas. BJOG 2005;112:317–320.
- Paulson RJ, Sauer MV, Lobo RA: Pregnancy after in vitro fertilization in a patient with stage I endometrial carcinoma treated with progestins. Fertil Steril 1990;54:735–736.
- Thornton JG, Brown LA, Wells M, Scott JS: Primary treatment of endometrial cancer with progestagen alone. Lancet 1985;2:207–208.
- Zanetta G, Gabreiele A, Losa G, Cappelini A, Mangioni C: Conservative management of endometrial carcinoma with prolonged preservation of the uterus in a young patient. Int J Gynecol Cancer 1997;7:332–334.
- Salha O, Martin-Hirsch P, Lane G, Sharma V: Endometrial carcinoma in a young patient with polycystic ovarian syndrome: first suspected at time of embryo transfer. Hum Reprod 1997;12:959–962.
- Ferrandina G, Zannoni GF, Gallotta V, Foti E, Mancuso S, Scambia G: Progression of conservatively treated endometrial carcinoma after full term pregnancy: a case report. Gynecol Oncol 2005;99:215–217.
- Greenblatt RB, Gambrell RD Jr, Stoddard LD: The protective role of progesterone in the prevention of endometrial cancer. Pathol Res Pract 1982;174:297–318.
- Mitsushita J, Toki T, Kato K, Fujii S, Konishi I: Endometrial carcinoma remaining after term pregnancy following conservative treatment with medroxyprogesterone acetate. Gynecol Oncol 2000;79:129–132.
- Muechler E, Bonfiglio T, Choate J, Huang KE: Pregnancy induced with menotropins in a woman with polycystic ovaries, endometrial hyperplasia, and adenocarcinoma. Feril Steril 1986;46:973–975.
- Lerner-Geva L, Geva E, Lessing JB, Chetrit A, Modan B, Amit A: The possible association between in vitro fertilization treatments and cancer developments. Int J Gynecol Cancer 2003;13:23–27.
- Lavie O: Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer. Obstet Gynecol 2004;103:997–998.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.