Departments of Obstetrics and Gynaecology, University of Ulsan College of Medicine, Asan Medical Center, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul National University College of Medicine, and Samsung Medical Center, Sungkyunkwan University of Medicine, Seoul, Korea.
Obstet Gynecol. 2013 Jul;122(1):7-14. doi: 10.1097/AOG.0b013e3182964ce3.
To estimate the oncologic and pregnancy outcomes after oral progestin treatment of women of reproductive age with stage IA endometrial adenocarcinoma with stage IA, grade 1 differentiation with superficial myometrial invasion or stage IA, grade 2-3 differentiation with or without superficial myometrial invasion.
Medical records of 48 women (age 40 years or younger) with endometrioid adenocarcinoma of the uterus who met inclusion criteria and were treated conservatively with oral progestin were reviewed. Follow-up was performed primarily with imaging techniques followed by endometrial biopsy when indicated.
The median age was 30 years (range, 23-40 years). Fourteen patients (29.2%) received daily oral megestrol acetate (median dose 160 mg per day, range 40-240 mg per day) and 34 (70.8%) received daily oral medroxyprogesterone acetate (median dose 500 mg per day, range 80-1,000 mg per day). Complete responses were observed for 37 patients (77.1%) after the median treatment duration of 10 months (range 3-20 months). Complete response rates were 76.5%, 73.9%, and 87.5% for patients with stage IA, grade 2-3 without myometrial invasion (n=17), for patients with stage IA, grade 1 with superficial myometrial invasion (n=23), and for patients with stage IA, grade 2-3 with superficial myometrial invasion (n=8), respectively (P=.731). Recurrence rates for 37 patients who achieved complete response after a median follow-up time of 48 months (range 7-136 months) were 23.1%, 47.1%, and 71.4%, respectively (P=.104). None experienced disease progression or died of the disease. Nine patients gave birth to 10 healthy newborns.
Progestin treatment appears to be reasonably effective for patients with stage IA, grade 2-3 differentiation without myometrial invasion and patients with stage IA grade 1 differentiation with superficial myometrial invasion.
III.
评估口服孕激素治疗分化程度为 IA 期、G1 级伴浅肌层浸润或 IA 期、G2-3 级伴或不伴浅肌层浸润且肿瘤局限于子宫内膜腺癌的生育期妇女的肿瘤学和妊娠结局。
对符合纳入标准并接受口服孕激素保守治疗的 48 例子宫内膜样腺癌患者（年龄 40 岁以下）的病历进行回顾性分析。主要通过影像学技术进行随访，必要时行子宫内膜活检。
中位年龄为 30 岁（范围 23-40 岁）。14 例（29.2%）患者每日口服甲羟孕酮（中位剂量为 160mg/天，范围 40-240mg/天），34 例（70.8%）患者每日口服甲孕酮（中位剂量为 500mg/天，范围 80-1000mg/天）。中位治疗 10 个月（范围 3-20 个月）后，37 例（77.1%）患者达到完全缓解。IA 期、无肌层浸润 G2-3 患者的完全缓解率为 76.5%、73.9%和 87.5%（n=17），IA 期、浅肌层浸润 G1 患者为 73.9%、73.9%和 87.5%（n=23），IA 期、浅肌层浸润 G2-3 患者为 73.9%、73.9%和 87.5%（n=8）（P=.731）。在中位随访时间为 48 个月（范围 7-136 个月）后，37 例完全缓解患者的复发率分别为 23.1%、47.1%和 71.4%（P=.104）。无疾病进展或因疾病死亡。9 例患者分娩了 10 名健康新生儿。
孕激素治疗对于无肌层浸润的 IA 期、G2-3 分化和伴浅肌层浸润的 IA 期、G1 分化的患者似乎是合理有效的。
III。
