J Gynecol Oncol.  2019 Jul;30(4):e62. 10.3802/jgo.2019.30.e62.

Conservative hysteroscopic treatment of stage I well differentiated endometrial cancer in patients with high surgical risk: a pilot study

• Casadio P
• Guasina F
• Talamo MR
• Paradisi R
• Morra C
• Magnarelli G
• Seracchioli R

• KMID: 2450241
• DOI: http://doi.org/10.3802/jgo.2019.30.e62

Abstract

OBJECTIVE
To report hysteroscopic treatment combined with levonorgestrel-releasing intrauterine device (LNG-IUD) to treat women with early well differentiated endometrial cancer (EC) at high surgical risk.
METHODS
Nine women diagnosed with stage IA, grade 1 endometrioid EC which was contraindicated or refused standard treatment with external beam radiation therapy with or without brachytherapy were enrolled in our prospective study. Endo-myometrial hysteroscopic resection of the whole uterine cavity and the placement of LNG-IUD for 5 years was performed. Response rate, perioperative complications, and recurrence of disease were evaluated.
RESULTS
None had intra or post-operative complications and all were discharged no later than the third day of hospitalization. After 6 months from surgery, all the women showed a complete regression of the lesion. All the women completed the 5 years follow-up and in no case was detected sign of recurrence. Two women died for causes unrelated to the tumor or the ongoing therapy.
CONCLUSION
The alternative treatment with endo-myometrial hysteroscopic resection and LNG-IUD in women with stage IA, grade 1 endometrioid EC showed initial encouraging outcomes in terms of effectiveness and safety.

Keyword

Endometrial Cancer; Hysteroscopic Surgery; Obesity; High Surgical Risk

MeSH Terms

Brachytherapy
Endometrial Neoplasms*
Female
Follow-Up Studies
Hospitalization
Humans
Hysteroscopy
Intrauterine Devices
Obesity
Pilot Projects*
Prospective Studies
Recurrence