Conservative hysteroscopic treatment of stage I well differentiated endometrial cancer in patients with high surgical risk: a pilot study

Abstract

Objective To report hysteroscopic treatment combined with levonorgestrel-releasing intrauterine device (LNG-IUD) to treat women with early well differentiated endometrial cancer (EC) at high surgical risk. Methods Nine women diagnosed with stage IA, grade 1 endometrioid EC which was contraindicated or refused standard treatment with external beam radiation therapy with or without brachytherapy were enrolled in our prospective study. Endo-myometrial hysteroscopic resection of the whole uterine cavity and the placement of LNG-IUD for 5 years was performed. Response rate, perioperative complications, and recurrence of disease were evaluated. Results None had intra or post-operative complications and all were discharged no later than the third day of hospitalization. After 6 months from surgery, all the women showed a complete regression of the lesion. All the women completed the 5 years follow-up and in no case was detected sign of recurrence. Two women died for causes unrelated to the tumor or the ongoing therapy. Conclusion The alternative treatment with endo-myometrial hysteroscopic resection and LNG-IUD in women with stage IA, grade 1 endometrioid EC showed initial encouraging outcomes in terms of effectiveness and safety.

Fertility Sparing Treatment of Endometrial Cancer with and without Initial Infiltration of Myometrium: A Single Center Experience

“…These outcomes are similar to those reported in the literature and show the efficacy of progestin therapy in superficial pre-neoplastic lesions [13,18]. Our study showed a complete remission at the first control in 94.4% of cases diagnosed with G1 EEC undergoing combined therapy and this finding agrees with those of other studies that indicated a response rate between 78% and 100% [6,7]. In our study, the cases of recurrence are slightly higher than those reported by Giampaolino et al [6], likely because we carried out a longer follow-up and included women with minimal myometrial infiltration.…”

“…These data highlight the importance of preserving fertility in these young women. The conservative management of early stage EC is generally well-accepted in young women wishing to preserve their fertility or in women who have severe surgical risk factors [6,7]. In fact, hysteroscopic resections accompanied by hormonal therapy for fertility-sparing treatment in young women with early-stage EC were reported in several studies [6,8,9], and it appears to be a reasonable opportunity in these cases with specific criteria.…”

Expression Pattern of Leptin and Its Receptors in Endometrioid Endometrial Cancer

“…In addition, there are often dosimetric and technical difficulties, which means that radiotherapy cannot be used. Therefore, there is a great need to search for therapeutic methods for women at high surgical risk [23].…”

Complete resection of an endometrial cancer lesion by hysteroscopic tumor resection combined with photodynamic diagnosis: a case report

“…5ALA: 5-aminolevurinic acid, PDD: photodynamic diagnosis. vice (LNG-IUD), due to surgical intolerance preventing a radical operation [13].…”