Treatment endometrium cancer with preserving fertility - analysis of literature data and own studies

Abstract

Spontaneous and distant results were analyzed concerning hormonal treatment of 47 initial patients of reproductive age with endometrium cancer (EC). The cure in the prof. N.N.Petrov scientific-research institute was performed from 1975 with purpose of preseiving fertility without operation. In addition, literature data concerning analogical treatment of 36 patients were analyzed. Summary of all data concerning 83 patients EC without invasion in myometrium show about 80% patients were receptive to hormonotherapy and 61% had the full regression of endometrium tumor. The pregnancy occurs in 20% of patients, childbirth happen in 12% of patients. Relapses of illness were revealed in almost one half of 66 patients (48%) after the full regression of initial EC. Unique results obtained in the prof. N.N. Petrov scientific-research institute oncological department are explained by large number of observations and long monitoring patients. These data analysis allowed to define indications and conditions for use of such cure EC method: only inpatients with minimal high-differentiated Aden carcinoma and in specialized clinics. This method does not exclude any timely surgery cure component in case of relapse and together with it permits to realize the reproductive function.

Keywords

reproductive age / cancer treatment / endometrium / hormonal treatment / fertility / complete regression of the primary ER / obesity and anovulation / infertility

References

[1] Бахидзе Е. В., Максимов С. Я., Чепик О.Ф. Частота бесплодия у больных раком эндометрия // Вопр. онкол. — 2002. — № 2.

[2] Бохман Я. В. Руководство по онкогинекологии. — Л.: Медицина, 1989. - С. 275-336

[3] Бохман Я. В., Чепик О. Ф., Волкова А. Т., Вишневский А. С. Возможно ли излечение первичного рака эндометрия I стадии с помощью рогетинов. // Вопр. онкол. — 1982. — № 3. — С. 34-42.

[4] Бохман Я. В., Бонтэ Я., Вишневский и соавт. Гэрмонотерапия рака эндометрия. — СПб.: Гиппократ. — 1992. - С. 120-135.

[5] Вишневский А. С., Максимов С. Я., Цырлина Е. В. и соавт. Клиникоэндокринологические особенности минимального рака тела матки // Новые подходы к лечению гинекологического рака. — СПб.: Гиппократ. — 1993. — С. 140-146.

[6] В. М. Дильман. Эндокринологическая онкология: Л.: Медицина. —1983. — С. 183-205.

[7] Максимов С. Я. Минимальный рак эндометрия. — СПб.: Гиппократ. — 1994. — С. 129-130.

[8] Новикова Е. Г., Чиссов В. 14., Чулкова О. Н. и соавт. Органосохраняющее лечение в онкогинекологии. — М., 2000. — С. 68-75.

[9] Онкологическая помощь населению // Под ред. В. М. Мерабишвили. — СПб., 2001. — С. 32-40.

[10] Онкологические аспекты ановуляции // Под ред. Я. В. Бохмана. — Псков, 1980. — С. 21-28.

[11] Фильченков А. А., Стойка Р. С. Апоптоз и рак. — Киев: Морион. — 1999. - С. 132.

[12] Andrews W. С., Andrews М. С. Stein-Leventhal syndrome with associated adenocarcinoma of the endometrium //Am. J. Obstet. Gynecol. — 1960. — Vol. 80. —P. 632-636.

[13] Crissman J. D., Azoury P. S., Barnes A. E., Schellhas H. F. Endometrial carcinoma in women 40 years of age or younger// Obstet. Gynecol. - 1981. - Vol. 57. -P. 699-704.

[14] Farhi D. S., Nosanchuk J., Silverberg S. G. Endometrial adenocarcinoma in women under 25 years old // Gynecol. Oncol. — 1986. - Vol. 68. - P. 741-745.

[15] Fechner R. E., Kaufman P. H. Endometrial adenocarcinoma in Stein-Leventhal syndrome // Cancer. - 1974. - Vol. 34. - P. 444-452.

[16] International Agency for Research of Cancer. WHO. Biennial Report 1996-1997. Lyon: IARC. - 1997. - P. 60-69.

[17] Jackson R. L., Dockerty M. B. The Stein-Leventhal syndrome: analysis of 43 cases with special reference to association with endometrial carcinoma //Am. J. Obstet. Gynecol. — 1957. — Vol. 73. - P. 161-173.

[18] Jobo T., Imai M., Kawaguchi M. et al. Successful conservative treatment of endometrial carcinoma permitting subsequent pregnancy: report of two cases // Eur. J. Gynaecol. Oncol. — 2000. — Vol. 21. — P. 119-122.

[19] Каки T., Yoshikawa H., Tsuda H. et al. Conservative therapy for adenocarcinoma and atypical endometrial hyperplasia of the endometrium in young women: central pathologic review and treatment outcome. Cancer Lett. — 2001 Jun 10; 167 (1): 39-48.

[20] Kempson P. L., Pokorny G. E. Adenocarcinoma of the endometrium in women aged 40 and younger // Cancer. — 1968. — Vol. 21. - P. 650-662.

[21] Kerr J. F. R., Wyllie A. H., Currie A. P. Apoptosis: a basic biological phenomenon with wide-ranging implications in tissue kinetics // Br. J. Cancer. - 1972. - Vol. 26. - P. 239-257.

[22] Kim Y. B., Holschneider С. H., Ghosh K. et.al. Progestin Alon as Primary Treatment of Endometrial Carcinoma in Premenopausal Women. Report of Seven Cases and Review of Literature // Cancer. — 1997. - Vol. 79. —N 1. - P. 320-327.

[23] Kimmig R., Strowitzki T., Muller- Hocker J. et al. Conservative treatment of endometrial cancer permitting subsequent triplet pregnancy // Gynecol. Oncol. — 1995. - Vol. 58. - P. 255-257.

[24] Kung F. T., Chen W. J., Chou H. H. Conservative management of early endometrial adenocarcinoma with repeat curettage and hormone therapy under assistance of hysteroscopy and laparoscopy. — Human Reproduction. — 1997. — Vol. 12. -N8.-P. 1649-1653.

[25] Lee K. R., Sculy R. E. Complex endometrial hiperplasia and carcinoma in adolescents and young women 15 to 20 years of age report of 10 cases // Int. J. Gynecol. Pathol. - 1989. - Vol. 8. - P. 201-213.

[26] Molecular aspects of cancer and is therapy / Ed A. Mackievich, P. B. Sehgal — Series «Molecular and cellular biology updates». — Basel, Boston, Berlin: Birhauser, 1998.

[27] Morrow С. P., Bundy В. N., Kurman R. J. et al. Relationshipbetween surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: a gynecologic oncology groupstudy // Gynecol. Oncol. - 1991. - Vol. 40. - P. 55-65.

[28] O’Neill R. T. Pregnancy following hormonal therapy for adenocarcinoma of the endometrium // Am. J. Obstet. Gynecol. - 1970. - Vol. 108. -P. 318-321.

[29] Saegusa M., Okayasu I. Frequent nuclear beta-catenin accumulation and associated mutations in endometrioid-type endometrial and ovarian carcinomas with squamous differentiation // J. Pathol. — 2001. - Vol. 194. - P. 59-67.

[30] Sehin к J. C., Rademaker A. W., Miller D. S., Lurain J. R. Tumour size in endometrial cancer//Cancer. — 1991. - Vol. 67. - P. 2791-2794.

[31] Scully R. E., Bonfiglio T. A., Kurman R. J. et al. Histological typing of female genital tract tumors // World Health Organization International Histological classification of Tumors. — Berlin: Springer-Verlag. — 1994. — P. 39-63.

[32] Thornton J. G. Brown L. A., Wells M., Scott J. S. Letter to the editor. Primary treatment of endometrial cancer with progestagen alaone // Lancet. — 1985. — Vol. ii. —P. 207-208.

[33] Tsoutsoplides G. C. Endometrial adenocarcinoma and the Stein- Leventhal syndrome //Am. J. Obstet. Gynecol. — 1983. — Vol. 147. - P. 844-845.

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