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. 2022 Apr 26;14(9):2170.
doi: 10.3390/cancers14092170.

Fertility-Sparing Treatment for Endometrial Cancer: Oncological and Obstetric Outcomes in Combined Therapies with Levonorgestrel Intrauterine Device

Ida Pino  1 , Anna Daniela Iacobone  1   2 , Ailyn Mariela Vidal Urbinati  1 , Maria Di Giminiani  3 , Davide Radice  4 , Maria Elena Guerrieri  1 , Eleonora Petra Preti  1 , Silvia Martella  1 , Dorella Franchi  1
Affiliations

Fertility-Sparing Treatment for Endometrial Cancer: Oncological and Obstetric Outcomes in Combined Therapies with Levonorgestrel Intrauterine Device

Ida Pino et al. Cancers (Basel). .

Abstract

Background: The prevalence of reaches up to 5% in women younger than 40 years. Therefore, the fertility preservation should be the goal of the clinical practice in women with desire of pregnancy and low-risk features. The aim of this study is to compare oncological and reproductive outcomes of different hormonal therapies in FST of EC.

Methods: A retrospective single-center study recruiting patients with presumed FIGO STAGE IA endometrioid G1 EC from 2005 to 2020 was performed. We assessed outcomes for three different therapeutic options: GnRHa + LNG-IUD vs. MA + LNG-IUD vs. MA + LNG-IUD + MET.

Results: In total, 75 patients were enrolled and followed up for a median of 45 months. Complete response (CR) was achieved in 75% of patients at 12 months. Although not statistically significant, we reported an increasing rate of CR from the regimen with GnRHa to the one with MA + MET (65% vs. 83%). We showed a statistically significant lower risk of recurrence in women treated with MA + LNG-IUD + MET, when compared to GnRHa + LNG-IUD regimen. The pregnancy rate was 74% and live birth rate was 42%, with no differences among regimens.

Conclusions: FST is a safe and effective option in women who desire to preserve fertility.

Keywords: endometrial cancer; fertility-sparing treatment; obstetric outcomes; oncological outcomes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cumulative incidence curves for relapse according to treatment.
Figure 2
Figure 2
Cumulative incidence curves for relapse according to post-treatment pregnancy status.
See this image and copyright information in PMC

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