Systemic and Local Hormone Therapy for Endometrial Hyperplasia and Early Adenocarcinoma

Hubbs, Jessica L.; Saig, Reagan M.; Abaid, Lisa N.; Bae‐Jump, Victoria L.; Gehrig, Paola A.

doi:10.1097/aog.0b013e31828d6186

Cited by 59 publications

(42 citation statements)

References 27 publications

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“…10 A few preliminary reports so far have documented that the use of LNG-IUD seems to be equally effective compared to oral progestins in terms of response rates in patients with EC. 26 Also, in a prospective observational study for the conservative management of 14 women with EC, only intrauterine progesterone releasing device and GnRH analog were used. Their results were comparable to studies using either MPA or MA with complete remission rate of 57% and recurrence rate of 25%.…”

Section: Stagevmyometrial Invasion According To Imagingmentioning

confidence: 99%

European Society of Gynecological Oncology Task Force for Fertility Preservation

Rodolakis

Biliatis

Morice

et al. 2015

International Journal of Gynecological Cancer

150

171

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Endometrial cancer (EC) in young women of reproductive age is a relatively rare diagnosis. However, since in the modern era women delay their childbearing for a variety of social reasons, more and more women in the near future will be nulliparous and have a diagnosis of EC at the same time. Hence, a more conservative approach of EC is desirable to preserve fertility of these women, without compromising their survival. Recently, the number of studies reporting encouraging results on fertility-sparing management of EC with high dose of progestins is increasing. It seems that preserving the uterus and the ovaries in a carefully selected patient with EC confers only a very small risk combined with an enormous benefit. Selection of women suitable for such a conservative approach, as well as method of treatment, follow-up, recurrence, obstetric outcomes, and survival rates are very important parameters when consulting women with EC wishing to preserve their fertility. In this article, we try to elucidate all the previously mentioned aspects and formulate clinical recommendations, based on published data, about the most proper approach and consultation of these patients.

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Section: Stagevmyometrial Invasion According To Imagingmentioning

confidence: 99%

European Society of Gynecological Oncology Task Force for Fertility Preservation

Rodolakis

Biliatis

Morice

et al. 2015

International Journal of Gynecological Cancer

150

171

View full text Add to dashboard Cite

show abstract

“…Additionally, a plasma signature containing miR-200b, miR-200c, miR-203 and miR-449a could distinguish myometrial invasion [138]. As many more young obese women are diagnosed with complex hyperplasia and want to maintain child bearing potential, the accurate diagnosis of complex hyperplasia and endometrial cancer is critical [148,149,[159][160][161][162][163][164]. Given that these miRNAs target members of the PI3K-AKT pathway, these miRNA may be useful plasma biomarkers (Table 3).…”

Section: Role Of Mirnas In Diagnosis Of Endometrial Cancermentioning

confidence: 99%

Role of microRNAs in cancers of the female reproductive tract: insights from recent clinical and experimental discovery studies

Logan

Hawkins

2014

Clinical Science

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microRNAs (miRNAs) are small RNA molecules that represent the top of the pyramid of many tumorigenesis cascade pathways as they have the ability to affect multiple, intricate, and still undiscovered downstream targets. Understanding how miRNA molecules serve as master regulators in these important networks involved in cancer initiation and progression open up significant innovative areas for therapy and diagnosis that have been sadly lacking for deadly female reproductive tract cancers. This review will highlight the recent advances in the field of miRNAs in epithelial ovarian cancer, endometrioid endometrial cancer and squamous-cell cervical carcinoma focusing on studies associated with actual clinical information in humans. Importantly, recent miRNA profiling studies have included well-characterized clinical specimens of female reproductive tract cancers, allowing for studies correlating miRNA expression with clinical outcomes. This review will summarize the current thoughts on the role of miRNA processing in unique miRNA species present in these cancers. In addition, this review will focus on current data regarding miRNA molecules as unique biomarkers associated with clinically significant outcomes such as overall survival and chemotherapy resistance. We will also discuss why specific miRNA molecules are not recapitulated across multiple studies of the same cancer type. Although the mechanistic contributions of miRNA molecules to these clinical phenomena have been confirmed using in vitro and pre-clinical mouse model systems, these studies are truly only the beginning of our understanding of the roles miRNAs play in cancers of the female reproductive tract. This review will also highlight useful areas for future research regarding miRNAs as therapeutic targets in cancers of the female reproductive tract.

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“…In a recent study of 186 women who received primary hormone therapy for endometrial hyperplasia or early-stage endometrioid cancer between January 1999 and July 2011, 153 women had adequate follow-up without surgery or radiation as part of their primary treatment. Among patients with cancer, the outcomes were not significantly different between the LNG-IUS and oral progesterone groups at all time points [11]. For patients with moderate to severe endometrial hyperplasia, hysterectomy may be considered after childbirth.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Levonorgestrel-Releasing Intrauterine System for Treating Endometrial Hyperplasia in Patients with Polycystic Ovary Syndrome

Lin

Wang

et al. 2014

Gynecol Obstet Invest

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Objective: To evaluate the use of a levonorgestrel-releasing intrauterine system (LNG-IUS) for treating endometrial hyperplasia in patients with polycystic ovary syndrome (PCOS). Methods: LNG-IUSs were inserted in 60 PCOS patients with simple (40 cases), irregular (12 cases), or complex (8 cases) endometrial hyperplasia. Follow-ups were performed at 3, 6, 12, and 24 months after insertion. At each time point, changes in menstruation, hemoglobin level, and endometrial thickness and pathology were recorded. Menstrual changes were assessed with the Pictorial Blood Assessment Chart. Hemoglobin levels were measured by the Blood Routine Test. Endometrial thickness was determined by transvaginal ultrasound. Endometrial pathology was defined as simple, irregular, or complex endometrial hyperplasia by a pathologist after curettage. Outcomes at each time point were compared to baseline (pre-insertion) measurements by Student's t test or ANOVA (for multiple comparisons) with the post hoc Dunnett's test. Differences with a p < 0.05 were considered statistically significant. Results: At all time points after LNG-IUS insertion and in all patients, menstrual blood loss was decreased and hemoglobin level was increased significantly compared to pre-insertion levels. The endometrial thickness was significantly reduced in all groups after 12 months. Most patients showed transformation of the endometrial pathology, with complete disappearance of simple and irregular cases of endometrial hyperplasia and a decreased number of complex endometrial hyperplasia cases. Conclusions: LNG-IUS is an effective, safe, nonsurgical, and atraumatic approach with few side effects for the treatment of endometrial hyperplasia in patients with PCOS.

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Systemic and Local Hormone Therapy for Endometrial Hyperplasia and Early Adenocarcinoma

Abstract: Hormone therapy has varied response rates among women with endometrial hyperplasia or cancer who do not undergo surgery. Close patient monitoring remains paramount given the high recurrence and high percentage of patients who will not respond.

Cited by 59 publications

References 27 publications

European Society of Gynecological Oncology Task Force for Fertility Preservation

European Society of Gynecological Oncology Task Force for Fertility Preservation

Role of microRNAs in cancers of the female reproductive tract: insights from recent clinical and experimental discovery studies

Evaluation of a Levonorgestrel-Releasing Intrauterine System for Treating Endometrial Hyperplasia in Patients with Polycystic Ovary Syndrome

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