| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 6183772 | Gynecologic Oncology | 2013 | 5 Pages |
ObjectiveTo analyze the outcomes of second round of fertility-sparing management using progestin in patients with recurrent endometrial cancer after successful fertility-sparing management using progestin.MethodsWe reviewed 45 patients who had recurrence after achieving complete remission by fertility-sparing management using progestin for presumed stage IA, grade 1, endometrioid adenocarcinoma of the uterus. Of 45 patients, 33 tried progestin re-treatment at recurrence and were included in this study.ResultsRecurrent disease was atypical hyperplasia in 13 patients (39%) and grade 1 endometrioid adenocarcinoma in 20 patients (61%) which were confined to the endometrium. Thirty patients (91%) received medroxyprogesterone acetate (dose range, 80-500Â mg/day) and three patients (9%) received megestrol acetate (dose range, 80-160Â mg/day), with 29 patients receiving a dose of 500Â mg/day of medroxyprogesterone acetate. The median duration of treatment was 6Â months (range, 3-19Â months). Five patients failed to respond to progestin re-treatment and underwent definitive surgical treatment including hysterectomy. Twenty eight patients (85%) showed complete response to progestin re-treatment. The median follow-up time after progestin re-treatment in 28 patients who achieved complete remission was 51Â months (range, 24-160Â months). During follow-up, five patients had second recurrence after median time interval of 14Â months (range, 4-82Â months). All patients who tried progestin re-treatment are alive without evidence of disease.ConclusionProgestin re-treatment in patients with recurrent endometrial cancer was effective and safe. Therefore, this can be recommended for young women who still want to preserve fertility at recurrence after complete response to progestin.
⺠Complete response rate and durable response rate to progestin re-treatment is very high. ⺠No one experienced disease progression during progestin re-treatment and follow-up. ⺠Progestin re-treatment can be a reasonable treatment option for patients with recurrent endometrial cancer.
