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

被引:57
作者
Gullo, Giuseppe [1 ]
Etrusco, Andrea [2 ]
Cucinella, Gaspare [1 ]
Perino, Antonino [1 ]
Chiantera, Vito [3 ]
Lagana, Antonio Simone [4 ]
Tomaiuolo, Rossella [5 ]
Vitagliano, Amerigo [6 ]
Giampaolino, Pierluigi [7 ]
Noventa, Marco [6 ]
Andrisani, Alessandra [6 ]
Buzzaccarini, Giovanni [6 ]
机构
[1] Univ Palermo, Dept Obstet & Gynecol, Villa Sofia Cervello Hosp, IVF UNIT, I-90146 Palermo, Italy
[2] Univ Palermo, Dept Obstet & Gynecol, Villa Sofia Cervello Hosp, I-90146 Palermo, Italy
[3] Univ Palermo, Dept Gynecol Oncol, I-90146 Palermo, Italy
[4] Univ Insubria, Dept Obstet & Gynecol, Filippo Del Ponte Hosp, I-21100 Varese, Italy
[5] Univ Vita Salute San Raffaele, I-20132 Milan, Italy
[6] Univ Padua, Dept Womens & Childrens Hlth, Gynaecol Clin, I-35128 Padua, Italy
[7] Univ Federico II Naples, Dept Publ Hlth, I-80138 Naples, Italy
关键词
endometrial cancer; fertility sparing; fertility preservation; ART; infertility; progestin; IUD; metformin; COMPLEX ATYPICAL HYPERPLASIA; POLYCYSTIC-OVARY-SYNDROME; YOUNG-WOMEN; CONSERVATIVE TREATMENT; HYSTEROSCOPIC SURGERY; CHIRO-INOSITOL; PREOPERATIVE TREATMENT; INTRAUTERINE SYSTEM; INSULIN SENSITIVITY; ONCOLOGIC OUTCOMES;
D O I
10.3390/ijms222111825
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
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.
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页数:12
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共 33 条
[31]   Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer [J].
Matsuo, Koji ;
Cripe, James C. ;
Kurnit, Katherine C. ;
Kaneda, Michiko ;
Garneau, Audrey S. ;
Glaser, Gretchen E. ;
Nizam, Aaron ;
Schillinger, Rachel M. ;
Kuznicki, Michelle L. ;
Yabuno, Akira ;
Yanai, Shiori ;
Garofalo, Denise M. ;
Suzuki, Jiro ;
St Laurent, Jessica D. ;
Yen, Ting-Tai ;
Liu, Annie Y. ;
Shida, Masako ;
Kakuda, Mamoru ;
Oishi, Tetsuro ;
Nishio, Shin ;
Marcus, Jenna Z. ;
Adachi, Sosuke ;
Kurokawa, Tetsuji ;
Ross, Malcolm S. ;
Horowitz, Max P. ;
Johnson, Marian S. ;
Kim, Min K. ;
Melamed, Alexander ;
Machado, Karime K. ;
Yoshihara, Kosuke ;
Yoshida, Yoshio ;
Enomoto, Takayuki ;
Ushijima, Kimio ;
Satoh, Shinya ;
Ueda, Yutaka ;
Mikami, Mikio ;
Rimel, Bobbie J. ;
Stone, Rebecca L. ;
Growdon, Whitfield B. ;
Okamoto, Aikou ;
Guntupalli, Saketh R. ;
Hasegawa, Kosei ;
Shahzad, Mian M. K. ;
Im, Dwight D. ;
Frimer, Marina ;
Gostout, Bobbie S. ;
Ueland, Frederick R. ;
Nagao, Shoji ;
Soliman, Pamela T. ;
Thaker, Premal H. .
GYNECOLOGIC ONCOLOGY, 2019, 155 (01) :39-50
[32]   Proteomic Analysis of Low-Grade, Early-Stage Endometrial Carcinoma Reveals New Dysregulated Pathways Associated with Cell Death and Cell Signaling [J].
Lopez-Janeiro, Alvaro ;
Ruz-Caracuel, Ignacio ;
Ramon-Patino, Jorge L. ;
De los Rios, Vivian ;
Esparza, Maria Villalba ;
Berjon, Alberto ;
Yebenes, Laura ;
Hernandez, Alicia ;
Masetto, Ivan ;
Kadioglu, Ece ;
Goubert, Virginie ;
Heredia-Soto, Victoria ;
Barderas, Rodrigo ;
Ignacio Casal, Jose ;
de Andrea, Carlos E. ;
Redondo, Andres ;
Mendiola, Marta ;
Pelaez-Garcia, Alberto ;
Hardisson, David .
CANCERS, 2021, 13 (04) :1-16
[33]   Fertility sparing surgery for stage IA type I and G2 endometrial cancer in reproductive-aged patients: evidence-based approach and future perspectives [J].
Salvatore Giovanni Vitale ;
Diego Rossetti ;
Alessandro Tropea ;
Antonio Biondi ;
Antonio Simone Laganà .
Updates in Surgery, 2017, 69 :29-34