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高分化子宫内膜癌的保守治疗:年轻女性何时以及为何应考虑采用该治疗方法。

Conservative treatment for well-differentiated endometrial cancer: when and why it should be considered in young women.

作者信息

Peiretti Michele, Congiu Francesca, Ricciardi Enzo, Maniglio Paolo, Mais Valerio, Angioni Stefano

机构信息

Department of Surgical Sciences, Division of Gynecology and Obstetrics, University of Cagliari, 09124 Cagliari, Italy.

Department of Gynäkologie and Gynäkologische Onkologie, Kliniken Essen-Mitte, 45136 Essen, Germany.

出版信息

Ecancermedicalscience. 2019 Jan 16;13:892. doi: 10.3332/ecancer.2019.892. eCollection 2019.

Abstract

The aim of this review was to update current knowledge on the conservative treatment of endometrial cancer (EC) based on a literature review. A web-based search in the MEDLINE database was carried out on EC management and treatment. All relevant information has been collected and analysed. Case series were mainly found in the literature search. Conservative treatments were offered to young patients with stage I low-grade endometrioid carcinomas of the endometrium. Different options included high/low dose progestin treatments, hysteroscopic resection of the disease, a levonorgestrel intrauterine device or a combination of various strategies. The overall complete response rate was near 76.5% with a recurrence rate of up to 33.8%. Pregnancy outcomes reached rates of 64.8% for live births. The current clinical outcomes show that conservative treatment aimed at preserving fertility is feasible for stage I endometrial well-differentiated adenocarcinomas in motivated patients under close monitoring.

摘要

本综述的目的是通过文献回顾更新子宫内膜癌(EC)保守治疗的现有知识。在MEDLINE数据库中对EC的管理和治疗进行了基于网络的检索。收集并分析了所有相关信息。文献检索中主要发现了病例系列。保守治疗适用于患有I期低级别子宫内膜样腺癌的年轻患者。不同的选择包括高/低剂量孕激素治疗、宫腔镜下疾病切除术、左炔诺孕酮宫内节育器或多种策略的联合应用。总体完全缓解率接近76.5%,复发率高达33.8%。活产的妊娠结局率达到64.8%。目前的临床结果表明,对于有生育意愿且在密切监测下的患者,针对I期高分化子宫内膜腺癌进行旨在保留生育能力的保守治疗是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9427/6369973/11f8fcb4b582/can-13-892fig1.jpg

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