Fertility-Sparing Approach in Women Affected by Stage I and Low-Grade Endometrial Carcinoma: An Updated Overview

International Journal of Molecular Sciences

Vito Chiantera¹  Gaspare Cucinella²  Giuseppe Gullo²  Antonino Perino²  Andrea Etrusco³  Antonio Simone Laganà⁴  Pierluigi Giampaolino⁵  Alessandra Andrisani⁶  Amerigo Vitagliano⁶  Marco Noventa⁶  Giovanni Buzzaccarini⁶  Rossella Tomaiuolo⁷ 

[1] Department of Gynecology Oncology, University of Palermo, 90146 Palermo, Italy;Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy;Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy;Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;Department of Public Health, University Federico II of Naples, 80138 Naples, Italy;Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy;Vita-Salute San Raffaele University, 20132 Milan, Italy;

关键词: endometrial cancer;    fertility sparing;    fertility preservation;    ART;    infertility;    progestin;   

DOI  :  10.3390/ijms222111825

来源: DOAJ

【 摘 要 】

Endometrial cancer (EC) is a deleterious condition which strongly affects a woman’s quality of life. Although aggressive interventions should be considered to treat high-grade EC, a conservative approach should be taken into consideration for women wishing to conceive. In this scenario, we present an overview about the EC fertility-sparing approach state of art. Type I EC at low stage is the only histological type which can be addressed with a fertility-sparing approach. Moreover, no myometrium and/or adnexal invasion should be seen, and lymph-vascular space should not be involved. Regarding the pharmaceutical target, progestins, in particular medroxyprogesterone acetate (MPA) or megestrol acetate (MA), are the most employed agent in conservative treatment of early-stage EC. The metformin usage and hysteroscopic assessment is still under debate, despite promising results. Particularly strict and imperious attention should be given to the follow-up and psychological wellbeing of women, especially because of the double detrimental impairment: both EC and EC-related infertility consequences.

【 授权许可】

Unknown