Hysteroscopy Management Of Stage â…  Endometrial Carcinoma For Fertility Preservation

Objective:To describe an innovative method to preserve fertility in young women with stage I endometrial carcinoma with use of hysteroscopic resection followed by administration of progestin and assess the feasibility.Materials and methods:The medical records of six young patients with stage I endometrial carcinoma, who were treated with hysteroscopic resection combined with progestin from July2004to December2012in Women’s Hospital, School of Medicine of Zhejiang University were retrospectively analyzed.Results:Median patient age was30.5years (range27-39years), four out of six referred a primary infertility, three had polycystic ovary syndrome, and two had myoma of uterus. For clinical stage, five were FIGO la, and the remaining one was FIGO Ib. Pathologic diagnoses at diagnostic hysteroscopy were six grade1endometrioid adenocarcinoma. All tumors were estrogen and progestin receptor positive. All patients obtained complete remission with duration of treatment, four out of six had peritoneal cytology detection and all were negative. At present, four out of six have given birth to five infants. Two cases received radical operation finally. Median follow-up time was86.5months (range16～104months), and none had recurrent disease during the follow-up time.Conclutions:The therapy of hysteroscopic surgery combined with progestin was feasible. This method, under a close postsurgical follow-up, might represent a novel therapeutic option for those women with stage I endometrial cancer who wish to preserve fertility.