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Tytuł pozycji:

Efficacy and fertility outcomes of levonorgestrel-releasing intra-uterine system treatment for patients with atypical complex hyperplasia or endometrial cancer: a retrospective study.

Tytuł :
Efficacy and fertility outcomes of levonorgestrel-releasing intra-uterine system treatment for patients with atypical complex hyperplasia or endometrial cancer: a retrospective study.
Autorzy :
Leone Roberti Maggiore U; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy. .
Martinelli F; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Dondi G; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Bogani G; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Chiappa V; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Evangelista MT; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Liberale V; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Ditto A; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
Ferrero S; Academic Unit of Obstetrics and Gynaecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
Raspagliesi F; Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy.
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Źródło :
Journal of gynecologic oncology [J Gynecol Oncol] 2019 Jul; Vol. 30 (4), pp. e57. Date of Electronic Publication: 2019 Feb 26.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Publication: June 2011-: Seoul : Asian Society of Gynecologic Oncology : Taehan Puin Chongyang Hakhoe
Original Publication: Seoul : Korean Society of Gynecologic Oncology and Colposcopy, June 2008-
MeSH Terms :
Intrauterine Devices, Medicated*
Carcinoma, Endometrioid/*drug therapy
Endometrial Hyperplasia/*drug therapy
Endometrial Neoplasms/*drug therapy
Fertility Preservation/*methods
Levonorgestrel/*administration & dosage
Adult ; Female ; Follow-Up Studies ; Humans ; Neoplasm Recurrence, Local ; Pregnancy ; Retrospective Studies
References :
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Contributed Indexing :
Keywords: Endometrial Cancer; Fertility; Hyperplasia; Levonorgestrel; Pregnancy
Substance Nomenclature :
5W7SIA7YZW (Levonorgestrel)
Entry Date(s) :
Date Created: 20190511 Date Completed: 20200309 Latest Revision: 20200309
Update Code :
20210209
PubMed Central ID :
PMC6543108
DOI :
10.3802/jgo.2019.30.e57
PMID :
31074240
Czasopismo naukowe
Objective: To investigate the efficacy of levonorgestrel-releasing intra-uterine system (LNG-IUS) treatment in patients affected by atypical complex hyperplasia/endometrial cancer (ACH/EC) wishing to preserve their fertility and to present fertility outcomes of those patients who actively tried to conceive.
Methods: Data of consecutive women with ACH/EC who underwent fertility-sparing treatment using LNG-IUS were retrospectively evaluated.
Results: Overall, 48 patients and the mean (±standard deviation) length of follow-up was 82.6±47.2 months. Among patients with ACH, 25/28 (89.3%) had a complete response (CR), 2/28 (7.1%) had a partial response (PR) and 1/28 (3.6%) had a progressive disease (PD). Mean (±standard deviation) time to CR was 6.7±4.0 months. Among patients with G1 EC, 13/16 (81.3%) had a CR, 1/16 (6.3%) had a PR and 2/16 (12.5%) had a PD. Mean (±standard deviation) time to CR was 5.0±2.9 months. Among patients with G2 EC, 3/4 (75.0%) had a CR and 1/4 (25.0%) had a PD. Mean (±standard deviation) time to CR was 4.0±0 months. Only 19 (39.6%) patients who had CR actually attempted to conceive. Eleven (57.9%) women tried to conceive naturally while 8 (42.1%) women underwent an in vitro fertilization (IVF). Fourteen (73.7%) patients wishing to conceive achieved a pregnancy (6 spontaneously and 8 through IVF).
Conclusions: Fertility-sparing treatment of patient with ACH/EC with LNG-IUS achieves high regression rates and good fertility outcomes. Future larger multi-institutional studies should be designed to confirm these preliminary findings.
(Copyright © 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.)
Comment in: J Gynecol Oncol. 2019 Jul;30(4):e79. (PMID: 31074232)

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