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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 02

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Ginecol Obstet Mex 2019; 87 (02)

Oncological and perinatal results of conservative treatment of fertility in patients with endometrial cancer treated with progestins

Arteaga-Gómez AC, Reyes-Muñoz E, Barros-Delgadillo JC, Delgado-Amador DE, Hernández-Cruz RG, Cerecedo-Ponce CV

Language: Spanish
References: 19
Page: 100-109
PDF size: 247.38 Kb.


ABSTRACT

Objective: To estimate the complete response rate and pregnancy in women with endometrial cancer who have received conservative treatment with progestins.
Materials and Methods: Cohort, retrolective and transversal study carried out in the National Institute of Perinatology, in women with endometrial cancer in early stages between 2007 and December 2016. Including patients between 18-40 years, nulliparous, with desire for fertility. The progestins used were megestrol, IUD-levonorgestrel and micronized progesterone for six months. Endometrial biopsy was performed at 6 and 12 months; The result was classified as a complete, partial response, persistence or progression of the disease. Descriptive statistics and comparisons between baseline measurements at six and 12 months are used using student grid and / or t tests according to the distribution of each variable. It is a statistical program SPSS version 23 for Windows (Chicago, USA).
Results: 11 women with endometrial cancer were included. The average age of the women was 32 ± 2.4 years. Morbidity associated with hypothyroidism and type 2 diabetes mellitus. Six-month biopsy was: complete response 6/11 partial response 2/11 and persistence 2/11, in one patient the biopsy was not performed at 6 months by pregnancy, there were no cases of progression. At 12 months of follow-up, there were 5 complete responses, 2 partial responses, 2 persistences, 1 case of disease progression and one case that discontinued treatment. Eight cycles of IVF were performed in 6 patients with a pregnancy rate of 25%, the duration of treatment was 19.3 ± 8 months, the total follow-up was 31.6 ± 13 months.
Conclusions: Conservative fertility therapy with progestins in women younger than 40 years old with early-stage endometrial cancer is feasible and secure in our institution. Pregnancy must be sought immediately after a full response to the cancer treatment. Our findings are similar to the ones found in our systematic review of the international bibliography.


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