Royal Women's Hospital, Parkville, Victoria, Australia.
Best Pract Res Clin Obstet Gynaecol. 2012 Jun;26(3):311-24. doi: 10.1016/j.bpobgyn.2011.12.007. Epub 2012 Jan 25.
Endometrial carcinoma is the most common gynaecological malignancy in the Western world. The standard management of endometrial carcinoma is total hysterectomy and bilateral salpingo-oophorectomy with or without pelvic and para-aortic lymph-node dissection. Increasingly, endometrial cancer is being diagnosed in younger women in whom preserving fertility may be an important consideration when deciding optimal management. Conservative management of endometrial carcinoma may be a therapeutic option in carefully selected women with well-differentiated endometrial cancer in the absence of any myometrial invasion or adnexal disease seen on imaging. The biggest concern with conservative management of endometrial carcinoma is disease progression while on treatment or after initial response to medical treatment. Women opting for conservative management should be aware that hormonal therapy is not the standard form of management. Potential adverse outcomes should be taken into consideration.
子宫内膜癌是西方世界最常见的妇科恶性肿瘤。子宫内膜癌的标准治疗方法是全子宫切除术和双侧输卵管卵巢切除术，伴或不伴盆腔和主动脉旁淋巴结清扫术。越来越多的年轻女性被诊断出患有子宫内膜癌，在决定最佳治疗方案时，保留生育能力可能是一个重要的考虑因素。对于分化良好的子宫内膜癌且无肌层浸润或影像学上未见附件疾病的患者，在仔细选择的情况下，保守治疗可能是一种治疗选择。保守治疗子宫内膜癌的最大问题是在治疗过程中或对药物初始反应后疾病进展。选择保守治疗的女性应该意识到激素治疗不是标准的治疗方法。应考虑潜在的不良后果。
