Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | e57 |
| Journal | Journal of Gynecologic Oncology |
| Volume | 30 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Jul 1 2019 |
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Keywords
- Endometrial Cancer
- Fertility
- Hyperplasia
- Levonorgestrel
- Pregnancy
ASJC Scopus subject areas
- Oncology
- Obstetrics and Gynaecology
Cite this
Efficacy and fertility outcomes of levonorgestrel-releasing intra-uterine system treatment for patients with atypical complex hyperplasia or endometrial cancer : a retrospective study. / Leone Roberti Maggiore, Umberto; Martinelli, Fabio; Dondi, Giulia; Bogani, Giorgio; Chiappa, Valentina; Evangelista, Maria Teresa; Liberale, Viola; Ditto, Antonino; Ferrero, Simone; Raspagliesi, Francesco.
In: Journal of Gynecologic Oncology, Vol. 30, No. 4, 01.07.2019, p. e57.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Efficacy and fertility outcomes of levonorgestrel-releasing intra-uterine system treatment for patients with atypical complex hyperplasia or endometrial cancer
T2 - a retrospective study
AU - Leone Roberti Maggiore, Umberto
AU - Martinelli, Fabio
AU - Dondi, Giulia
AU - Bogani, Giorgio
AU - Chiappa, Valentina
AU - Evangelista, Maria Teresa
AU - Liberale, Viola
AU - Ditto, Antonino
AU - Ferrero, Simone
AU - Raspagliesi, Francesco
PY - 2019/7/1
Y1 - 2019/7/1
N2 - 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.
AB - 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.
KW - Endometrial Cancer
KW - Fertility
KW - Hyperplasia
KW - Levonorgestrel
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85067269234&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067269234&partnerID=8YFLogxK
U2 - 10.3802/jgo.2019.30.e57
DO - 10.3802/jgo.2019.30.e57
M3 - Article
C2 - 31074240
AN - SCOPUS:85067269234
VL - 30
SP - e57
JO - Journal of Gynecologic Oncology
JF - Journal of Gynecologic Oncology
SN - 2005-0380
IS - 4
ER -