Yazbeck C, Dhainaut C, Thoury A, Driguez P, Madelenat P
Service de gynécologie-obstétrique, hôpital Bichat-Claude-Bernard, Paris, France.
Gynecol Obstet Fertil. 2004 May;32(5):433-41. doi: 10.1016/j.gyobfe.2004.01.017.
Endometrial carcinoma is the most frequent pelvic cancer encountered in women. The discovery of an endometrial carcinoma in a woman seeking pregnancy cannot be considered as exceptional. The medical alternative to the classic radical surgical treatment is studied in a review. Treatment with progestins might be considered and discussed with the couple in special indications. The oncologic risk to which this treatment exposes is limited. However, the application and the surveillance of this therapeutic protocol must obey strict rules, in order to recognize without delay any resistance to treatment. The spontaneous fertility of such patients seems weak, most probably because of their age, but assisted reproductive techniques (ART) could be considered in particular cases. Secondary hysterectomy is controversial, but a recent tendency is to widen this practice is becoming apparent.
子宫内膜癌是女性中最常见的盆腔癌症。在寻求怀孕的女性中发现子宫内膜癌并非罕见。本文综述研究了经典根治性手术治疗之外的医学替代方案。在特定指征下,可考虑使用孕激素治疗并与患者夫妇进行讨论。这种治疗所带来的肿瘤学风险是有限的。然而,为了能及时识别任何治疗抵抗,该治疗方案的应用和监测必须遵循严格的规则。这类患者的自然生育能力似乎较弱,很可能是由于其年龄因素,但在特定情况下可考虑辅助生殖技术(ART)。二次子宫切除术存在争议,但最近扩大这种手术应用的趋势正变得明显。