Tock Stéphanie, Jadoul Pascale, Squifflet Jean-Luc, Marbaix Etienne, Baurain Jean-François, Luyckx Mathieu
Department of Gynecology, Université catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
Front Med (Lausanne). 2018 Aug 27;5:240. doi: 10.3389/fmed.2018.00240. eCollection 2018.
To evaluate the efficacy and safety of gonadotropin-releasing hormone (GnRH) agonist after endometrial resection in women suffering early stage endometrial carcinoma (EC) and/or endometrial intra-epithelial neoplasia (EIN). A retrospective review of clinical files between January 1999 and December 2016. University hospital. Eighteen women younger than 41 years with grade 1 endometrial carcinoma (G1EC) and/or Endometrial intra-epithelial neoplasia (EIN).
All patients received GnRH agonist for 3 months after an endometrial resection combined with a laparoscopy to exclude concomitant ovarian tumor and/or other extra-uterine disease. The patient underwent a follow-up of 3 months interval with endometrial sampling by hysteroscopy. The recurrence rate and the pregnancy rate after fertility sparing treatment. We identified 9 patients with EIN (50%), 7 patients with G1EC (38.9%), 1 with combined histology (5.5%), and 1 with G2EC (5.5%). After a median follow-up of 40.7 months, 12 patients conserved their uterus (66.7%), and 8 (53.3%) patients were pregnant with a total of 14 pregnancies among those who tried to become pregnant. We observed a complete response rate in 12 patients (66.7%) but 3 of these patients relapsed (25%). We also found a stable disease in 6 patients (33.3%). Compared with other fertility sparing treatments, GnRH agonist after surgery is an effective fertility-sparing strategy for women with EIN and/or G1EC. We recommend hysterectomy once a family has been completed even if the literature does not clearly lead to radical surgery.
评估促性腺激素释放激素（GnRH）激动剂在早期子宫内膜癌（EC）和/或子宫内膜上皮内瘤变（EIN）女性患者子宫内膜切除术后的疗效和安全性。对1999年1月至2016年12月期间的临床档案进行回顾性研究。大学医院。18名年龄小于41岁的1级子宫内膜癌（G1EC）和/或子宫内膜上皮内瘤变（EIN）患者。
所有患者在子宫内膜切除术后联合腹腔镜检查以排除合并卵巢肿瘤和/或其他子宫外疾病后，接受3个月的GnRH激动剂治疗。患者每3个月进行一次宫腔镜子宫内膜取样随访。保留生育功能治疗后的复发率和妊娠率。我们确定9例EIN患者（50%），7例G1EC患者（38.9%），1例组织学合并类型患者（5.5%），1例G2EC患者（5.5%）。中位随访40.7个月后，12例患者保留了子宫（66.7%），8例（53.3%）患者怀孕，在尝试怀孕的患者中共14次妊娠。我们观察到12例患者（66.7%）完全缓解，但其中3例复发（25%）。我们还发现6例患者（33.3%）病情稳定。与其他保留生育功能的治疗方法相比，术后GnRH激动剂对EIN和/或G1EC女性是一种有效的保留生育功能策略。即使文献未明确导致根治性手术，我们仍建议一旦完成生育就进行子宫切除术。
