Gynecologic oncology · 2026
Fertility-sparing treatment in stage IA grade 2 endometrioid endometrial cancer: Outcomes of a standardized approach.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Catena Ursula, Dinoi Giorgia, Masciullo Valeria, D'Alessandris Nicoletta, Minucci Angelo, Fossatelli Alessia, Piermattei Alessia, La Fera Eleonora, Bonetti Palermo Emma, Perrone Emanuele, De Bonis Maria, Giannarelli Diana, Corrado Giacomo, Zannoni Gian Franco, Fagotti Anna, Fanfani Francesco
Аннотация
OBJECTIVE: To evaluate oncologic and reproductive outcomes of fertility-sparing treatment in women with stage IA grade 2 endometrioid endometrial cancer (EEC) without myometrial invasion treated with a standardized protocol.
METHODS: Consecutive women diagnosed with stage IA grade 2 EEC without myometrial invasion between June 2019 and August 2024 at a single tertiary center were treated with hysteroscopic resection followed by combined progestin therapy with oral megestrol acetate (MA) 160 mg/day and a levonorgestrel intrauterine device (LNG-IUD).
RESULTS: Twenty-five patients were included; median follow-up was 33 (IQR 12-90) months and median age 34 years (IQR 20-41). Complete response (CR) was achieved in 100% (25/25), with 84% at 6 months. Median time to CR was 6 months (range 6-12). Fifteen patients (60%) attempted conception, and 8 (53.3%) achieved pregnancy. Three delivered at term, three pregnancies are ongoing, and two resulted in miscarriage. Recurrence occurred in 56.0% (14/25) with a median time of 16.6 months. Six patients underwent definitive surgery, while eight were successfully retreated conservatively and are disease-free. Overall, 24/25 (96%) showed no evidence of disease at last follow-up. Most tumors were mismatch repair proficient (95.4%), none p53-mutated, with high ER/PR expression. All tested cases harbored β-catenin mutations. No treatment-related complications were observed.
CONCLUSIONS: A standardized fertility-sparing approach combining hysteroscopic resection and progestins achieved effective and safe management in stage IA grade 2 EEC without myometrial invasion, with favorable reproductive outcomes. These findings support its use in carefully selected patients, although longer follow-up is needed.
METHODS: Consecutive women diagnosed with stage IA grade 2 EEC without myometrial invasion between June 2019 and August 2024 at a single tertiary center were treated with hysteroscopic resection followed by combined progestin therapy with oral megestrol acetate (MA) 160 mg/day and a levonorgestrel intrauterine device (LNG-IUD).
RESULTS: Twenty-five patients were included; median follow-up was 33 (IQR 12-90) months and median age 34 years (IQR 20-41). Complete response (CR) was achieved in 100% (25/25), with 84% at 6 months. Median time to CR was 6 months (range 6-12). Fifteen patients (60%) attempted conception, and 8 (53.3%) achieved pregnancy. Three delivered at term, three pregnancies are ongoing, and two resulted in miscarriage. Recurrence occurred in 56.0% (14/25) with a median time of 16.6 months. Six patients underwent definitive surgery, while eight were successfully retreated conservatively and are disease-free. Overall, 24/25 (96%) showed no evidence of disease at last follow-up. Most tumors were mismatch repair proficient (95.4%), none p53-mutated, with high ER/PR expression. All tested cases harbored β-catenin mutations. No treatment-related complications were observed.
CONCLUSIONS: A standardized fertility-sparing approach combining hysteroscopic resection and progestins achieved effective and safe management in stage IA grade 2 EEC without myometrial invasion, with favorable reproductive outcomes. These findings support its use in carefully selected patients, although longer follow-up is needed.