Chiva Luis, Lapuente Fernando, González-Cortijo Lucia, Carballo Natalia, García Juan F, Rojo Alejandro, Gonzalez-Martín Antonio
Department of Gynecologic Oncology, MD Anderson International España, Madrid, Spain.
Gynecol Oncol. 2008 Nov;111(2 Suppl):S101-4. doi: 10.1016/j.ygyno.2008.07.056. Epub 2008 Sep 18.
The objective of this review is to recognize the characteristics of endometrial adenocarcinoma in young patients and to evaluate the published experience with conservative approach in patients with endometrial adenocarcinoma. We searched MEDLINE articles describing patients with endometrial adenocarcinoma who were treated with hormonal therapy. The search included articles published between January 1966 and January 2007. Endometrial carcinoma in patients under 45 years of age is an unusual condition that shows a more favorable pattern than in older patients. One hundred thirty three patients were found in the search. The average duration of hormonal therapy was approximately 6 months. The average response time was 12 weeks. Seventy six percent of patients treated with hormonal therapy had a complete response and the other 24% never responded to treatment. Of those who initially responded, 66% didn't show recurrence of disease. The other 34% had a relapse. There have been published 4 deaths of patients conservatively managed. A conservative approach in these patients can offer reasonable oncological security and the opportunity of fulfilling their maternal desires in selected cases. However, consideration should be taken regarding the potential adverse outcomes that have been recently published in the literature.
本综述的目的是认识年轻子宫内膜腺癌患者的特征，并评估已发表的关于子宫内膜腺癌患者保守治疗方法的经验。我们检索了MEDLINE中描述接受激素治疗的子宫内膜腺癌患者的文章。检索范围包括1966年1月至2007年1月发表的文章。45岁以下患者的子宫内膜癌是一种不常见的疾病，其表现出比老年患者更有利的模式。检索中发现了133例患者。激素治疗的平均持续时间约为6个月。平均反应时间为12周。接受激素治疗的患者中，76%有完全反应，另外24%对治疗无反应。在最初有反应的患者中，66%未出现疾病复发。另外34%复发。已有4例保守治疗患者死亡的报道。对这些患者采取保守治疗方法可提供合理的肿瘤学安全性，并在某些选定病例中提供实现其生育愿望的机会。然而，应考虑到近期文献中发表的潜在不良后果。
