Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Tock, Stéphanie; Jadoul, Pascale; Squifflet, Jean-Luc; Marbaix, Étienne; Baurain, Jean‐François; Luyckx, Mathieu

doi:10.3389/fmed.2018.00240

Cited by 47 publications

(53 citation statements)

References 43 publications

(76 reference statements)

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“…Endometrial cancer treatment often involves surgical removal of the uterus, ovaries, uterine tubes, and pelvic and paraaortic lymph nodes [40]. In the case of reproductive-aged women, fertility-sparing treatment is possible, however, it requires further standardization and development in order to provide the patient with access to various solutions [41,42]. It is important to look for complementary molecular markers that allow for an earlier and more precise diagnosis, as it can provide more treatment options and allow for the development of strategies that will be as non-invasive as possible for the patient.…”

Section: Discussionmentioning

confidence: 99%

Interplay between miRNAs and Genes Associated with Cell Proliferation in Endometrial Cancer

Hermyt

Zmarzły

Grabarek

et al. 2019

IJMS

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Endometrial cancer develops as a result of abnormal cell growth associated with uncontrolled cell proliferation, excessive activation of signaling pathways and miRNA activity. The aim of this study was to determine the expression profile of genes associated with cell proliferation and to assess which miRNAs can participate in the regulation of their expression. The study enrolled 40 patients with endometrial cancer and 10 patients without neoplastic changes. The expression profile of genes associated with cell proliferation and the expression profile of miRNAs were assessed using microarrays. RT-qPCR was performed to validate mRNA microarray results. The mirTAR tool was used to identify miRNAs that regulate the activity of genes associated with cell proliferation. Decreased expression of IGF1 and MYLK, as well as SOD2 overexpression, were observed in endometrial cancer using both mRNA microarrays and RT-qPCR. Microarray analysis showed low levels of NES and PRKCA, but this was only partially validated using RT-qPCR. Reduced activity of MYLK may be caused by increased miR-200c, miR-155 and miR-200b expression. Cell proliferation is disturbed in endometrial cancer, which may be associated with an overexpression of miR-200a, miR-200c, and miR-155, making it a potential diagnostic marker.

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Section: Discussionmentioning

confidence: 99%

Interplay between miRNAs and Genes Associated with Cell Proliferation in Endometrial Cancer

Hermyt

Zmarzły

Grabarek

et al. 2019

IJMS

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“…Once lymphatic metastasis (LM) occurs, the prognosis is very poor. 2 According to the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system, the proportions of stage IIIC1 and IIIC2 tumors in patients with EC are 2.3% and 1.2%, respectively. The 5-year survival rates for patients with stage IIIC1 and IIIC2 tumors are 57.0% and 49.4%, respectively.…”

Section: Introductionmentioning

confidence: 99%

The characteristics of isolated para-aortic lymph node metastases in endometrial cancer and their prognostic significance

Guo

Qian

et al. 2020

Ther Adv Med Oncol

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Background: The aim of this study was to clarify the features and prognostic significance of isolated para-aortic lymphatic metastasis of endometrial cancer. Methods: A retrospective study of patients with stage IIIC endometrial cancer was performed based on the Surveillance, Epidemiology, and End Results (SEER) database. A total of 2767 patients were divided into three groups according to the lymphatic metastasis patterns: isolated pelvic lymphatic metastasis, isolated para-aortic lymphatic metastasis and dual lymphatic metastasis. The clinic-pathological characteristics and prognosis of patients were compared among the three groups. Result: The proportion of patients with isolated para-aortic lymphatic metastasis was 13.70%. Patients with isolated pelvic lymphatic metastasis or isolated para-aortic lymphatic metastasis shared similar histological characteristics, except that patients with isolated para-aortic lymphatic metastasis had a lower proportion of tumors over 5 cm in diameter than patients with isolated pelvic lymphatic metastasis (35.1% versus 45.7%, p = 0.001). Compared with patients with dual lymphatic metastasis, isolated para-aortic lymphatic metastasis was more common in patients with endometrioid tumors (78.6% versus 67.3%, p < 0.001), grade 1–2 cancers (53.3% versus 36.3%, p < 0.001) and negative peritoneal cytology (76.2% versus 61.1%, p < 0.001). Dual lymphatic metastasis was an independent predictive factor for the poor outcomes of patients at stage IIIC. However, in stage IIIC endometrioid tumors, patients with isolated pelvic lymphatic metastasis and those with isolated para-aortic lymphatic metastasis shared similar prognosis. Patients at stage IIIC with nonendometrioid tumors and patients at stage IV could not be further divided into subgroups according to lymphatic metastasis patterns in terms of prognosis. Conclusion: Endometrioid patients with isolated pelvic lymphatic metastasis and isolated para-aortic lymphatic metastasis share similar clinical pathological characteristics and prognoses.

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“…Endometrial sampling was performed by hysteroscopy at the initial diagnosis and every 3 months during treatment. The histologies were reviewed according to the World Health Organization system by two pathologists specializing in gynecologic oncology 9. After a pathological complete response, the patients were monitored for recurrence every 3–6 months.…”

Section: Introductionmentioning

confidence: 99%

Impact of treatment duration in fertility-preserving management of endometrial cancer or atypical endometrial hyperplasia

Wang

Zhou

Wang

et al. 2019

Int J Gynecol Cancer

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ObjectiveFertility preservation is an option for selected patients with endometrial hyperplasia or cancer. This study aimed to evaluate whether duration of treatment impacts the oncologic and reproductive outcomes.MethodsWe retrospectively reviewed patients diagnosed with endometrial cancer/atypical endometrial hyperplasia who underwent fertility-sparing treatment from January 2012 to December 2016. As the duration of treatment required by the patients was different, the patients who achieved a complete response were grouped according to the treatment duration as groups A (≤6 months), B (6–9 months), and C (>9 months).ResultsWith the prolongation of treatment duration from 6 months to 9 months to >9 months, the accumulative complete response rates for 67 patients were 58%, 76%, and 95.5%, respectively. Among groups A, B, and C there was no significant difference in the relapse rates (21.1%, 25%, and 36.4%, respectively, p=0.60) or the median time interval to relapse (14, 13, and 13.5 months, respectively, p=0.90). Maintenance treatment was an independent protective factor for recurrence (p=0.001), while the complication of diabetes was an independent risk factor for recurrence (p=0.03). Fertility rates (31%, 18.2%, and 62.5%, respectively, p=0.12) and the time interval to pregnancy (14, 13, and 8 months, respectively, p=0.67) were not significantly different among the three groups. Assisted reproductive technology was positively associated with a higher pregnancy rate (p=0.02) and a body mass index ≥25 kg/m2 was negatively associated with the pregnancy rate (p=0.047).ConclusionsLonger treatment duration was associated with higher rates of complete response. Longer treatment duration (>9 months) was not associated with a decrease in success rates of pregnancy.

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Fertility Sparing Treatment in Patients With Early Stage Endometrial Cancer, Using a Combination of Surgery and GnRH Agonist: A Monocentric Retrospective Study and Review of the Literature

Cited by 47 publications

References 43 publications

Interplay between miRNAs and Genes Associated with Cell Proliferation in Endometrial Cancer

Interplay between miRNAs and Genes Associated with Cell Proliferation in Endometrial Cancer

The characteristics of isolated para-aortic lymph node metastases in endometrial cancer and their prognostic significance

Impact of treatment duration in fertility-preserving management of endometrial cancer or atypical endometrial hyperplasia

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