ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR

Atipik Hiperplazi/Endometrioid İntraepitelyal Neoplazi/Endometrial Kanserde Fertilite Koruyucu Tedavi: Bir Üçüncül Kanser Merkezi Deneyimi
Fertility-Sparing Treatment in Women with Atypical Hyperplasia/Endometrioid Intraepithelial Neoplasia/ Endometrial Cancer: A Tertiary Cancer Center Experience
Received Date : 27 Jun 2022
Accepted Date : 15 Sep 2022
Available Online : 26 Sep 2022
Doi: 10.24074/tjrms.2022-92149 - Makale Dili: EN
TJRMS. 2022;6(1):128-34
ÖZET
Amaç: Bu çalışma, endometriyal atipik hiperplazi (AH), endometrioid intraepitelyal neoplazi (EIN) ve endometrioid adenokarsinom (EC) hastalarında fertilite koruyucu tedavi sonrası onkolojik ve obstetrik sonuçları değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Üçüncü basamak bir jinekolojik kanser merkezinde Şubat 2014 ile Temmuz 2020 arasında fertilite koruyucu tedavi uygulanan AH/EIN ve EC'li hastaların kayıtlarını geriye dönük olarak inceledik. Medyan takip süresi 52 (6-75) ay idi. Bulgular: Tam yanıt oranı %75.9 idi. EC'li hastaların tamamı (n=2) 6 aylık tedaviden sonra stabil hastalığa sahipti. AH/EIN'li 27 hastanın 22'sinde (%81,5) 6-12 aylık tedaviden sonra tam yanıt alındı. AH/EIN hastalarından ikisi grade 1 endometrioid endometrial kansere ilerledi ve AH/EIN hastalarının 3'ünde 6 aylık tedavi süresi boyunca stabil hastalık vardı. AH/EIN grubundaki 13 (%59.1) hastada tam yanıt alma süresi ≤6 ay ve 9 (%40.9) hastada >6 ay idi. Tam yanıttan sonra AH/EIN olan bir hasta spontan gebe kaldı ve sağlıklı bir doğum yaptı. Nüks oranı %9.1 idi. Sonuç: Endometrial karsinom veya düşük dereceli endometrium kanseri öncü lezyonları olan ve fertilitesini korumak isteyen kadınlarda fertilite koruyucu tedavi modaliteleri yakın takiple uygulanabilir.
ABSTRACT
Objective: The present study aims to evaluate the oncological and obstetric outcomes after fertility-sparing treatment in patients with endometrial atypical hyperplasia (AH), endometrioid intraepithelial neoplasia (EIN), and endometrioid adenocarcinoma (EC). Materials and Methods: We retrospectively analyzed the records of patients with AH/EIN and EC who underwent fertility-preserving treatment in a tertiary gynecological cancer center between February 2014 and July 2020. The median follow-up was 52 (range, 6-75) months. Results: The complete response rate was 75.9%. All of the patients with EC (n=2) had stable disease after the treatment of 6 months. Twenty-two (81.5%) patients of 27 patients with AH/EIN had a complete response after the treatment of 6-12 months. Two of AH/EIN patients progressed to grade 1 endometrioid endometrial cancer, and 3 of AH/EIN patients had stable disease during the 6-month treatment period. The time to complete response was ≤6 months in 13 (59.1%) and >6 months in 9 (40.9%) patients in the AH/EIN group. One patient with AH/EIN after complete response became pregnant spontaneously and she gave a healthy birth. The recurrence rate was 9.1%. Conclusion: Fertility-sparing treatment modalities could be feasible in women with precursor lesions of endometrial carcinoma or low-grade endometrial cancer who want to preserve their fertility within close follow- up.
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