Consultant, Department of Surgery, Changi General Hospital, Singapore, Singapore.
Consultant, Department of Gynaecological Oncology, Division of O&G, KK Women's and Children Hospital, Singapore, Singapore.
Cancer Rep (Hoboken). 2023 Sep;6(9):e1857. doi: 10.1002/cnr2.1857. Epub 2023 Jul 5.
Obesity is a major risk factor in the development of endometrial cancer (EC) in young patients of reproductive age. Fertility sparing treatment is a viable option for a select group of patients with early EC, and involves systemic and intra-uterine hormonal therapy. Weight loss has been associated with improved outcomes in this group. Bariatric surgery (BS) has been shown to be the most efficient and durable method of weight loss in obese patients. However, there is a paucity of data studying the benefit of BS as part of fertility sparing treatment.
We present a retrospective case series of five patients who are undergoing fertility sparing treatment for early EC, who also underwent BS for treatment of obesity and related comorbidities. We aim to show early regression of EC for all the patients and also report on the other health benefits of BS.
All five patients in the series achieved regression of EC within 6 months of undergoing BS. They also achieved significant weight loss consistent with previous studies, and three patients who had comorbidities related to obesity had remission of these conditions. One of the patients with EC regression also managed to conceive with IVF (In-vitro Fertilisation).
Patients on fertility sparing treatment for early EC who underwent BS was associated with early regression within 6 months, significant weight loss and resolution of comorbidities. BS could be a promising component of fertility sparing treatment. Long term, prospective studies are required to confirm the benefits reported in this case series.
肥胖是年轻育龄期子宫内膜癌（EC）发展的主要危险因素。对于早期 EC 的特定患者群体，保留生育能力的治疗是一种可行的选择，包括全身和宫内激素治疗。在这组患者中，体重减轻与改善结局相关。减重手术（BS）已被证明是肥胖患者最有效和持久的减肥方法。然而，关于 BS 作为保留生育能力治疗的一部分的益处的数据很少。
我们报告了五例正在接受早期 EC 保留生育能力治疗的患者的回顾性病例系列，这些患者也因肥胖和相关合并症而行 BS。我们旨在显示所有患者的 EC 早期消退，并报告 BS 的其他健康益处。
该系列中的所有五例患者在接受 BS 后 6 个月内均实现了 EC 的消退。他们还实现了与先前研究一致的显著体重减轻，并且有 3 例与肥胖相关的合并症患者这些情况得到缓解。在 EC 消退的患者中，有 1 例也成功通过体外受精（IVF）受孕。
对于正在接受早期 EC 保留生育能力治疗的患者，BS 与 6 个月内的早期消退、显著的体重减轻和合并症的缓解相关。BS 可能是保留生育能力治疗的一个有前途的组成部分。需要长期、前瞻性研究来证实本病例系列报告的益处。
