Outcome of fertility-preserving treatment in young women with endometrial carcinomas

Objective To evaluate the outcome of conservative treatment of young women with endometrial cancer. Design Observational study. Setting Gifu University Hospital, Japan from 1988 to 2002. Population Twelve women with endometrial cancer, FIGO IA estimated by MRI under 35 years. Methods Patients were treated with medroxyprogestreone acetate (400 - 600 mg/day) for 6 - 10 months, with endometrial curettage performed every four weeks. Main outcome measures Response to therapy, pregnancies and reoccurrence of disease during follow up over a 30-month period. Results All cases had pathological complete remissions within 6 - 10 months. Seven of 10 wishing to have babies conceived, and five of them were delivered of full-term babies. Eight of nine cases receiving long term follow up (over 30 months) developed recurrent disease, with four opting for hysterectomy. No patient developed distant metastases or had disease-related death. Conclusion Conservative therapy is feasible in carefully selected young women with endometrial cancer. Recurrence rates were high during long term observation even after pathological complete remissions. Therefore, close follow up is recommended.