Successful conservative treatment of endometrial carcinoma permitting subsequent pregnancy: report of two cases

Two women with endometrial carcinoma who wished to preserve their childbearing ability received conservative treatment by medroxyprogesterone acetate (MPA, 600 mg/day for 22 weeks and 29 weeks, respectively). Following regression of endometrial lesions, their infertility was treated by inducing ovulation. Intact pregnancy was diagnosed 13 months and 11 months after completion of the MPA treatment, respectively. One patient had a twin pregnancy and delivered two infants at 35 weeks of gestational age. The other patient delivered a full-term baby. They had no evidence of recurrence 60 months and 31 months after the conservative treatment, respectively. We believe this conservative treatment with progestin may be safely performed for young patients with endometrial cancer who wish to preserve their fertility.

Endometrial carcinoma; Conservative therapy; Progestin; Fertility

[1] Jobo T.: "The effect of the screening for endometrial carcinoma". Acta Obst. Gynaec. Jpn., 1998, 50, N307 (In Japanese).

[2] Jobo T.,O hkawara S.,T suchiya G., Kuramoto H.. Arai M.: "Chnicopathological analysis of endometrial carcinoma in young women". J. Jpn. Soc. Cancer Ther., 1989, 24, 2362.

[3] Crissman J.,A zoury R. S., Barnes A.E .,S chellha、 H. F.: "Endometrial carcinoma in women 40 years of age or younger". Obstet Gynecol., 1981, 57. 699.

[4] Gallup D. G., Stock R. I.: "Adenocarcinoma of the endometnum in women 40 years of age or younger". Obstet. Gynecol., 1984, 64, 417.

[5] Gusberg S. B.: "Estrogen and endometriaI cancer". Gynecol Oncol., 1994, 52, 3.

[6] Bokhman J. Y.,C hepick 0. F., Volkova A.T ., VishNevsky A. S.: "Can primary endometrial carcinoma stage I be cured without surgery and radiation therapy". Gyneco/. Oncol., 1985, 20, 139.

[7] Thornton J. G., Brown L.A., Wells M., Scott J. S.: "Letter to the editor:Primary treatment of endometrial cancer with progestagen alone". Lancet, 1985, 2, 207.

[8] Kistner R. W.:'Treatment of hyperplasia and carcinoma in situ of the endometrium". Clin. Obstet. Gynecol., 1982, 25, 63.

[9] Kennedy B. J.: "Progestogens in the treatment of carcinoma of the endometrium". Surg. Gynecol. Obstet., 1968, 127, 103.

[10] Gusberg S. 8.: "Evolution of modern treatment of corpus cancer" Cancer, 1976. 38, 603.

[11] Kelley R. M., Baker W. H.: "Effects of 17 alpha hydroxyprogesterone caproate on metastatic endometrial cancer. Conference on experimental clinical cancer chemotherapy". Natl. Cancer Inst Monogr., 1960, 9, 235.

[12] Bokhman J. V.,C hepick 0. F., Volkova A. T., Vishnevsky A. S.: "Adjuvant hormone therapy of primary endometrial carcinoma with ox yprogesterone caproate". Gynecol. Oneal., 1981, 11, 371.

[13] Randall T. C., Kurman R. J.: "Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40". Ohstet. Gynecol., 1997, 90, 434.

[14] Kim Y. B.,H olschneider C.H., Ghosh K., Nieberg R. K., Montz F. J.: "Progestin alone as primary treatment of endometrial carcinoma in premenopausal women". Cancer, 1997, 79, 320.

[15] Christopherson W. M.,C onnelly P. J.,A lberhasky R.C .: "CarCJnoma of the endometrium. V. An analysis of prognosticators in patients with favorable subtypes and stage I disease". Cancer, 1983, 51, 1705.

[16] Gitsch G., Hanzal E., Jensen D., Hacker N. F.: "Endometrial cancer on premenopausal women 45 years and younger". Ohstet. Gynecol., 1995, 85, 504.

[17] Vergote I., Kjorstat K.,A beler V., Kolstad P.: "A randomized trial of adjuvant progestagen in early endometrial cancer". Cancer, 1989, 64, 1011.

[18] Quinn M.A., Kneale B. J., Fortune D. W.: "Endometrial carcinoma in premenopausal women". Gynecol. Oneal., 1985, 20, 298.

[19] Kmmig R., Strowitzki T., Muller-Hocker J., Kurzi R., Korell M., Hepp H.: "Case report. Conservative treatment of endometrial cancer permitting subsequent triplet pregnancy". Gynecol. Oneal., 1995, 58, 255

[20] Niwa K., Morishita S.,H ashimoto M., Yokoyama Y., Tamaya T: "Conservative therapy for endometrial carcinoma in young women treated with repeated curettage and progestogen". Int. J. Clin. Oncol., 1997, 2, 165.

[21] O'Neill R. T.: "Pregnancy following hormonal therapy for adenocarcinoma of the endometrium". Am. J. Obstet. Gynecol., 1970, 108, 318.

[22] Farhi D. C., Nosanchuk J., Silverberg S. G.: "Endometrial adenocarcinoma in women under 25 years of age". Obstet. Gynecol., 1986, 68, 741.

[23] Ohkawara S., Jobo T., Kuramoto H., Nishijima M.: "Two cases with endometrial carcinoma treated by hormone therapy". Kanagawa Dist. J. Jpn. Obstet. Gynecol., 1996, 32, 153.