Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov 26;18(11):3111-3116.
doi: 10.22034/APJCP.2017.18.11.3111.

Polycystic Ovarian Morphology may be a Positive Prognostic Factor in Patients with Endometrial Cancer who Achieved Complete Remission after Fertility-Sparing Therapy with Progestin

Yamato Fukui  1 , Ayumi Taguchi, Katsuyuki Adachi, Marie Sato, Akira Kawata, Michihiro Tanikawa, Kenbun Sone, Mayuyo Mori, Kazunori Nagasaka, Yoko Matsumoto, Takahide Arimoto, Katsutoshi Oda, Yutaka Osuga, Tomoyuki Fujii
Affiliations

Polycystic Ovarian Morphology may be a Positive Prognostic Factor in Patients with Endometrial Cancer who Achieved Complete Remission after Fertility-Sparing Therapy with Progestin

Yamato Fukui et al. Asian Pac J Cancer Prev. .

Abstract

Background: The most studied fertility-sparing therapy for endometrial cancer (EC) is oral progestin therapy. However, complete remission (CR) rate after progestin therapy is not enough ranging from 60 to 80 %, with high recurrence rate. Clinical features that predict treatment efficacy and recurrence after progestin therapy have not yet been revealed in detail. The aim of this study was to investigate prognostic factors in patients with EC who achieved CR after medroxyprogesterone acetate (MPA) therapy. Methods: We retrospectively reviewed 35 EC patients treated with MPA at our institution between 2000 and 2016. Following confirmation of endometrioid adenocarcinoma G1, patients orally took 600 mg MPA daily for 26 weeks. Patients with CR periodically took oral contraceptives. The association of recurrence-free survival (RFS) with several clinical features including age, body mass index (BMI), and polycystic ovarian morphology (PCOM) was analyzed. Results: Of 35 patients, 25 (71%) achieved CR, whereas 10 (29%) underwent hysterectomy due to failure of MPA therapy. Eleven (44%) of 25 patients with CR successfully gave birth after MPA therapy, whereas 8 (32%) developed recurrence. On univariate analysis, PCOM was significantly associated with better recurrence-free survival (RFS) (P=0.009), and BMI ≥25 kg/m2 exhibited a nonsignificant trend for longer RFS (P=0.0674). Although multivariate analysis failed to detect any valid hazard ratio (HR), absence of PCOM and non-obesity were both independent risk factors for recurrence (P=0.00293 and P=0.0201, respectively). Notably, none of 10 cases with PCOM experienced recurrence under maintenance with oral contraceptives. Conclusion: PCOM might be a good prognostic factor in those achieving CR after MPA therapy for EC.

Keywords: Endometrial cancer; fertility; sparing therapy; medroxyprogesterone acetate; polycystic ovarian morphology.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patients’ Outcome after Medroxyprogesterone Acetate (MPA) Therapy and Pregnancy Outcome of Patients with Complete Remission (CR)
Figure 2
Figure 2
Kaplan-Meier Survival Curve for Recurrence-Free Survival (RFS). (a), Overall; (b), Survival curves according to PCOM (polycystic ovarian morphology)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Carmina E, Wong L, Chang L, et al. Endocrine abnormalities in ovulatory women with polycystic ovaries on ultrasound. Hum Reprod. 1997;12:905–9. - PubMed
    1. Chiva L, Lapuente F, González-Cortijo L, et al. Sparing fertility in young patients with endometrial cancer. Gynecol Oncol. 2008;111:101–4. - PubMed
    1. Cormio G, Martino R, Loizzi V, Resta L, Selvaggi L. A rare case of choroidal metastasis presented after conservative management of endometrial cancer. Int J Gynecol Cancer. 2006;16:2044–8. - PubMed
    1. Crissman JD, Azoury RS, Barnes AE, et al. Endometrial carcinoma in women 40 years of age or younger. Obstet Gynecol. 1981;57:699–704. - PubMed
    1. Dorais J, Dodson M, Calvert J, et al. Fertility-sparing management of endometrial adenocarcinoma. Obstet Gynecol Surv. 2011;66:443–51. - PubMed