Obstetrics & Gynecology

Skip Navigation LinksHome > July 2013 - Volume 122 - Issue 1 > Hormonal Therapy for Women With Stage IA Endometrial Cancer...
Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3182964ce3
Original Research

Hormonal Therapy for Women With Stage IA Endometrial Cancer of All Grades

Park, Jeong-Yeol MD, PhD; Kim, Dae-Yeon MD, PhD; Kim, Tae-Jin MD, PhD; Kim, Jae Weon MD, PhD; Kim, Jong-Hyeok MD, PhD; Kim, Yong-Man MD, PhD; Kim, Young-Tak MD, PhD; Bae, Duk-Soo MD, PhD; Nam, Joo-Hyun MD, PhD

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Abstract

OBJECTIVE: To estimate the oncologic and pregnancy outcomes after oral progestin treatment of women of reproductive age with stage IA endometrial adenocarcinoma with stage IA, grade 1 differentiation with superficial myometrial invasion or stage IA, grade 2–3 differentiation with or without superficial myometrial invasion.

METHODS: Medical records of 48 women (age 40 years or younger) with endometrioid adenocarcinoma of the uterus who met inclusion criteria and were treated conservatively with oral progestin were reviewed. Follow-up was performed primarily with imaging techniques followed by endometrial biopsy when indicated.

RESULTS: The median age was 30 years (range, 23–40 years). Fourteen patients (29.2%) received daily oral megestrol acetate (median dose 160 mg per day, range 40–240 mg per day) and 34 (70.8%) received daily oral medroxyprogesterone acetate (median dose 500 mg per day, range 80–1,000 mg per day). Complete responses were observed for 37 patients (77.1%) after the median treatment duration of 10 months (range 3–20 months). Complete response rates were 76.5%, 73.9%, and 87.5% for patients with stage IA, grade 2–3 without myometrial invasion (n=17), for patients with stage IA, grade 1 with superficial myometrial invasion (n=23), and for patients with stage IA, grade 2–3 with superficial myometrial invasion (n=8), respectively (P=.731). Recurrence rates for 37 patients who achieved complete response after a median follow-up time of 48 months (range 7–136 months) were 23.1%, 47.1%, and 71.4%, respectively (P=.104). None experienced disease progression or died of the disease. Nine patients gave birth to 10 healthy newborns.

CONCLUSION: Progestin treatment appears to be reasonably effective for patients with stage IA, grade 2–3 differentiation without myometrial invasion and patients with stage IA grade 1 differentiation with superficial myometrial invasion.

LEVEL OF EVIDENCE: III

© 2013 by The American College of Obstetricians and Gynecologists.

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