Optimal duration of fertility-sparing hormonal treatment for early-stage endometrioid endometrial cancer
- Authors
- Shim, S.-H.; Chae, S.H.; So, K.A.; Lee, S.J.; Lee, J.Y.; Kim, T.J.; Han, E.S.; Kang, S.-B.
- Issue Date
- Jun-2021
- Publisher
- Academic Press Inc.
- Keywords
- Conservative treatment; Endometrial cancer; Fertility; Progestins
- Citation
- Gynecologic Oncology, v.161, no.3, pp 810 - 816
- Pages
- 7
- Indexed
- SCIE
SCOPUS
- Journal Title
- Gynecologic Oncology
- Volume
- 161
- Number
- 3
- Start Page
- 810
- End Page
- 816
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/52999
- DOI
- 10.1016/j.ygyno.2021.03.032
- ISSN
- 0090-8258
1095-6859
- Abstract
- Objectives: To analyze the oncologic outcomes of long-term fertility-sparing treatment (FST) in patients with early-stage endometrial cancer (EC) and to determine the optimal duration of FST that would not hamper survival outcomes. Methods: Patients undergoing FST for presumed stage IA, grade 1 EC between 2005 and 2018 were retrospectively analyzed. Oncologic outcomes were compared between the group with ≤6 months of FST and the group with >6 months of FST. Segmented regression analysis was used to estimate the dynamic changes in cumulative complete response (CR) rates according to FST duration. Results: A total of 122 patients received oral progestin, with concurrent levonorgestrel-releasing intrauterine device use in 108 (88.5%) and 105 (86.1%) achieved CR with a median time to achieve CR of 10 (3–42) months. Of the patients not achieving CR at 6 months of FST, 95.1% (78/82) continued further FST. The overall CR rate (88.9% [32/36] vs. 84.9% [73/86], P = 0.436] was not significantly different between the groups with ≤6 and > 6 months of FST. The changes in cumulative CR rates were significantly different between the two segments divided by 15 months from the initial FST (P = 0.0015, segmented regression analysis). The overall progressive disease (PD) rate was 3.3% (4/122), and PD was first detected during 9–12 months of FST. Conclusion: Patients not achieving CR and not showing PD at 6 months of FST could continue further FST. If disease progression is excluded, 15 months of FST can be considered as the cutoff for the optimal FST duration. © 2021 Elsevier Inc.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - 2. Clinical Science > Department of Obstetrics and Gynecology > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.