Innovative Follow-up Strategies for Endometrial Cancer

Contemporary Fertility-Sparing Management Options of Early Stage Endometrioid Endometrial Cancer in Young Nulliparous Patients

“…EC incidence is increasing all over the world, especially in developing countries [ 68 , 69 , 70 ]. According to the United Kingdom statistics, it has increased by 50% in recent decades [ 69 ].…”

“…According to the United Kingdom statistics, it has increased by 50% in recent decades [ 69 ]. Moreover, the age of women diagnosed with EC is becoming younger, while many of them are in their reproductive age [ 21 , 70 , 71 , 72 ]. Young women before the age of 40 represent 5% of all EC patients, and the majority of them are nulliparous at the time of diagnosis [ 72 , 73 ].…”

“…When a diagnosis of EC is established, the disease is localized in 67% of patients, while 20% of women will have regional and 9% distant metastasis [ 8 ]. Management of EC comprises total hysterectomy with bilateral salpingo-oophorectomy and pelvic and para-aortic lymph node dissection/biopsy [ 8 , 70 , 72 , 75 , 76 , 77 ]. However, because EC is increasingly affecting younger women, this approach is not appropriate for reproductive-age patients.…”

“…With the decreasing average age of EC patients at diagnosis [ 21 , 70 , 71 , 72 ], demands for fertility-sparing therapy have increased. Unfortunately, even with the well-developed treatment approaches, the feasibility and safety of continuing medical treatment in poor responders to conservative therapy is not clear yet and remains under investigation [ 90 ].…”

“…The overall aims of follow-up after an EC remission are to detect recurrence and provide holistic survivorship care [ 70 ]. Traditional follow-up models suggest three to six monthly clinical visits for the first two to three years, followed by six monthly or annual visits up to five years in total from diagnosis [ 70 ].…”