Signorelli M, Caspani G, Bonazzi C, Chiappa V, Perego P, Mangioni C
Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, University of Milan-Bicocca, Milan, Italy.
BJOG. 2009 Jan;116(1):114-8. doi: 10.1111/j.1471-0528.2008.02024.x.
We conducted a prospective study of conservative treatment in 21 young nulliparous women with grade (G)1 endometrial cancer stage IA (11) or atypical complex hyperplasia (10). All were treated with a low-dose cyclic natural progestin therapy (200 mg/day from day 14-25) and encouraged to attempt pregnancy immediately. No adverse therapy-related effects were recorded. Overall response rate to progestin therapy was 57%. Nine women conceived (43%). There were 13 pregnancies, of which 13 were spontaneous and 8 were in women with persistent disease or partial response to hormonal treatment. Three additional complete responses were observed after delivery. Only women with known primary infertility or severe polycystic ovary syndrome showed inadequate pregnancy rate. Fifteen women underwent definitive surgery after enrolment (median 27 months, range 3-56 months). All 21 women are alive and disease free after a median follow up of 98 months.
我们对21名患有IA期1级子宫内膜癌（11例）或非典型复杂性增生（10例）的未生育年轻女性进行了保守治疗的前瞻性研究。所有患者均接受低剂量周期性天然孕激素治疗（从第14天至25天每天200毫克），并被鼓励立即尝试怀孕。未记录到与治疗相关的不良影响。孕激素治疗的总体缓解率为57%。9名女性怀孕（43%）。共有13次妊娠，其中13次为自然妊娠，8次发生在患有持续性疾病或对激素治疗部分缓解的女性中。产后又观察到3例完全缓解。只有已知原发性不孕症或严重多囊卵巢综合征的女性妊娠率不足。15名女性在入组后接受了确定性手术（中位时间27个月，范围3 - 56个月）。在中位随访98个月后，所有21名女性均存活且无疾病。
