Outcomes of the conservative management of the patients with endometrial intraepithelial neoplasia/endometrial cancer: Wait or treat!

Authors: ESRA İŞÇİ BOSTANCI, YASİN DURMUŞ, SİNEM AYŞE DURU ÇÖTELİ, FULYA KAYIKÇIOĞLU, NURETTİN BORAN

Abstract: Background/aim: The objective of the study was to evaluate the response, relapse, reproductive results and demographic features of the patients with endometrioid adenocancer (EAC) and endometrial intraepithelial neoplasia (EIN) who were treated with conservative treatment. This is the largest study when we consider the single center studies in this field. Materials and methods: In the current retrospective study, 38 patients (6 EAC, 31 EIN, 1 synchronous tumors of ovary and endometrium) were recruited. They were treated with progesterone products for their fertility desire and comorbidity. Reproductive results, response rates, and recurrence rates were calculated and survival analyses were performed. Results: Mean duration of the medical treatment was 10 months (range 2-60). Among the 32 patients with EIN, 28 (87.5%) had a response, 8 (25%) had a relapse and 4 (12.5%) had persistence. Among the 32 patients who expecting fertility, seven patients got pregnant (21.8%) with a total of five live births. The median follow-up was 40.5 months (range 3-180), and recurrence-free interval was 28.7 months (range 2-180). Conclusion: Fertility-sparing treatment of EAC and EIN is a feasible approach, and the eligible patients should be given a chance to get pregnant.

Keywords: Fertility-sparing treatment, endometrial cancer, endometrial intraepithelial neoplasia, reproductive outcome, survival

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