Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Gangnam CHA Medical Center, CHA University, Seoul, Republic of Korea.
Gynecol Oncol. 2017 Jul;146(1):39-43. doi: 10.1016/j.ygyno.2017.05.002. Epub 2017 May 16.
To evaluate the influence of body weight change during fertility-sparing progestin therapy on oncologic and reproductive outcomes in young women with early-stage endometrial cancer who did not complete child bearing.
This multicenter, retrospective study included 154 young patients with well-differentiated, endometrium-confined endometrioid endometrial adenocarcinoma on magnetic resonance imaging who received fertility-sparing progestin therapy.
The mean body weight and body mass index (BMI) at baseline and progestin therapy completion was 65.3±16.2 and 66.5±15.9kg (P=0.044), respectively, and 25.51±5.99 and 25.99±5.94kg/m (P=0.034), respectively. During progestin therapy, 51 (33.1%), 29 (18.8%), and 74 patients (48.1%) had weight loss, no weight change, and weight gain, respectively, of which 11 (7.1%) had 10% weight loss and 30 (19.5%) had 10% weight gain. A pretreatment BMI of ≥25kg/m was significantly associated with a lower complete response rate to progestin therapy (P=0.003) and a high recurrence rate (P=0.033). A posttreatment BMI of ≥25kg/m was also a significant factor for high recurrence rate (P=0.049). However, weight change during therapy was not significantly associated with complete response or recurrence rate. Pre and posttreatment BMIs and weight change were not associated with pregnancy and live birth rates.
Weight change during progestin therapy has little influence on complete response, recurrence, pregnancy, and live birth rates. However, pre and posttreatment BMIs of ≥25kg/m were significant predictors for poor treatment response and high recurrence. Therefore, it is important to maintain patients' normal BMIs during progestin therapy.
评估在未完成生育的年轻早期子宫内膜癌患者中，孕激素治疗期间体重变化对保留生育功能的孕激素治疗的肿瘤学和生殖结局的影响。
本多中心回顾性研究纳入了 154 名经磁共振成像诊断为分化良好、局限于子宫内膜的子宫内膜样腺癌的年轻患者，这些患者接受了保留生育功能的孕激素治疗。
基线和孕激素治疗完成时的平均体重和体重指数（BMI）分别为 65.3±16.2kg 和 66.5±15.9kg（P=0.044），25.51±5.99kg 和 25.99±5.94kg/m（P=0.034）。在孕激素治疗期间，51（33.1%）、29（18.8%）和 74 名（48.1%）患者分别出现体重减轻、体重无变化和体重增加，其中 11 名（7.1%）体重减轻 10%，30 名（19.5%）体重增加 10%。治疗前 BMI≥25kg/m 与孕激素治疗完全缓解率较低（P=0.003）和高复发率（P=0.033）显著相关。治疗后 BMI≥25kg/m 也是高复发率的显著因素（P=0.049）。然而，治疗期间的体重变化与完全缓解或复发率无关。治疗前后的 BMI 和体重变化与妊娠和活产率无关。
孕激素治疗期间的体重变化对完全缓解、复发、妊娠和活产率影响不大。然而，治疗前后 BMI≥25kg/m 是治疗反应不佳和高复发的显著预测因素。因此，在孕激素治疗期间保持患者的正常 BMI 很重要。
