Fertility sparing treatment in young patients with early endometrial adenocarcinoma

Objective: the aim of this study was to evaluate fertility-sparing therapy in young patients with endometrial carcinoma. methodology: this prospective study was carried out on 8 patients with clinical and radio-graphic stage ia, well differentiated endometrioid adenocarcinoma of the endometrium in alzahra hospital, tabriz, iran. treatment comprised high-dose megestrol acetate. dilatation and curettage was repeated every three months. results: the mean age of the patients was 30 (sd,3.21) years (range 24-35). of the 8 patients, 7 (87.5%) achieved complete response. the mean time to response was 6.5 months (range 3-9). of the complete responders, 3 of 7(42.8%) had recurrence; one patient underwent immediate hysterectomy, and 2 were successfully treated with second-line therapy and both subsequently conceived. conception occurred in 3 of 7 patients (42.8%), in two more than once, however successful pregnancy occurred only in two patients. one patient developed concomitant ovarian adenocarcinoma. conclusions: high dose progestin therapy can be an effective fertility-sparing treatment in young patients with well differentiated stage ia endometrial endometrioid cancer confined to endometrium. however, close follow up is required because of risks of conservative treatment.