子宫内膜癌保留生育功能治疗的前瞻性研究

目的研究早期子宫内膜癌保留生育功能患者筛选方法、治疗方案及生育后的处理。方法收集2004年1月至2014年6月符合入组标准的9例年轻早期子宫内膜癌患者进行前瞻性研究。通过保留生育功能的治疗，对患者临床病理和预后资料进行回顾性分析。结果9例早期子宫内膜癌患者，孕激素治疗反应率为100%，6例（66.7%）完全反应（CR），3例（33.3%）部分反应（PR）。达到CR的中位服药时间为6个月。其中1例成功怀孕并分娩，1例妊娠中，3例复发。复发患者中1例行分期手术，1例再次服用孕激素保守治疗并获得二次完全缓解，停药12个月复发而行手术治疗。3例PR患者中1例接受分期手术治疗，2例拒绝手术者接受二线保守治疗。9例患者长期随访，均无瘤生存至今。结论口服大剂量孕激素保守治疗年轻妇女早期子宫内膜癌是安全有效的。

Fertility-preserving treatment in young women with endometrial adenocarcinoma

Objective To evaluate the feasibility of fertility-preserving treatment for young women with early-stage endometrial carcinoma. Methods Nine young women with early-stage endometrial carcinoma received high-dose megestrol acetate-based therapy for fertility preservation between January 2004 and June 2014. The clinical and demographic data were obtained from medical records and the follow-up visits were carried out by telephone questionnaires; and their outcomes were retrospectively analyzed. Results All patients responded to progestins, including 6 cases of complete response (CR, 66.7%) and 3 cases of partial response (PR, 33.3%). Among 6 cases of CR, 1 had full-term delivery, 1 was pregnant, 3 had disease recurrence. Among 3 cases of CR, 2 underwent definitive surgical treatment, and 1 patient received progestin treatment again, but late underwent definitive surgical treatment due to recurrence. All the patients survived with tumor free. Conclusion The study demonstrates the feasibility of high-dose megestrol acetate-based therapy of fertility preservation for young women with early-stage endometrial carcinoma.