Shan Weiwei, Wu Pengfei, Yang Bingyi, Zhang Hongwei, Sun Li, Lv Qiaoying, Luo Xuezhen, Cheng Yali, Zhu Qin, Chen Xiaojun
Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Department of Gynecology, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
J Obstet Gynaecol Res. 2021 Mar;47(3):984-991. doi: 10.1111/jog.14646. Epub 2021 Jan 5.
To explore the clinical outcomes of megestrol acetate alone or plus metformin in young women with grade 2 stage IA endometrial carcinoma who ask for preserved fertility.
Patients with stage IA grade 2 endometrial carcinoma who asked for fertility-sparing treatment in the Obstetrics and Gynecology Hospital of Fudan University between 2015 and 2017 were enrolled and retrospectively reviewed.
Four patients were included and treated with oral megestrol acetate (160 mg per day), while metformin (500 mg, thrice daily) was added for patients with metabolic syndrome. Regular hysteroscopic examination was performed every 3 months during the conservative treatment. Overall, 75% (3/4) of the patients had a complete response, one relapsed and achieved a complete response after changing the therapy plan, and one patient had an indication of myometrial invasion during fertility-sparing treatment and chose to remove uterus.
Fertility-sparing treatment for stage IA grade 2 endometrial carcinoma patients is worth exploration. Megestrol acetate with or without metformin combined with hysteroscopic lesion ablation may be an effective therapy.
探讨醋酸甲地孕酮单独使用或联合二甲双胍对有保留生育能力需求的年轻IA期2级子宫内膜癌患者的临床疗效。
纳入2015年至2017年期间在复旦大学附属妇产科医院要求保留生育功能治疗的IA期2级子宫内膜癌患者，并进行回顾性分析。
共纳入4例患者，给予口服醋酸甲地孕酮（每日160毫克），对合并代谢综合征的患者加用二甲双胍（500毫克，每日三次）。在保守治疗期间，每3个月进行一次常规宫腔镜检查。总体而言，75%（3/4）的患者获得完全缓解，1例复发，在更改治疗方案后获得完全缓解，1例患者在保留生育功能治疗期间出现肌层浸润迹象，选择切除子宫。
IA期2级子宫内膜癌患者的保留生育功能治疗值得探索。醋酸甲地孕酮联合或不联合二甲双胍并结合宫腔镜下病灶切除术可能是一种有效的治疗方法。
