Endometrial cancer and fertility

被引:39
作者
Rackow, Beth W. [1 ]
Arici, Aydin [1 ]
机构
[1] Yale Univ, Sch Med, Dept Obstet Gynecol & Reprod Sci, Dept Reprod Endocrinol & Infertil, New Haven, CT 06520 USA
关键词
conservative management; endometrial cancer; fertility preservation; stage I endometrial cancer;
D O I
10.1097/01.gco.0000193012.11523.c5
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Purpose of review Endometrial cancer can affect reproductive-age women who may desire fertility preservation. This article discusses the current, available data about conservative management of endometrial cancer in young women. Recent findings Reproductive-age women with well differentiated endometrial carcinoma have an overall favorable prognosis provided that the tumor is identified at an early, noninvasive stage; however, advanced disease can be present. This article discusses current modalities to evaluate and clinically stage endometrial cancer including hysteroscopy,, dilation and curettage, pelvic ultrasound, abdominopelvic computed tomography, pelvic magnetic resonance imaging, tumor marker CA125 level, and surgical exploration with laparoscopy or laparotomy. Thorough evaluation is critical as 10 to 29% of young women with endometrial cancer have a synchronous ovarian malignancy. Detailed counseling about the risks and benefits of conservative management, and expectations for fertility after treatment, surveillance, and definitive surgical management is essential. Multiple effective protocols exist for conservative treatment of endometrial cancer, and the initial response rates are as high as 57 to 75%. Successful pregnancies have occurred after conservative management, spontaneously and with assisted reproductive technologies. Summary There are no standard recommendations for selection of appropriate women, treatment protocols, or long-term surveillance for conservative management of clinical stage I endometrial adenocarcinoma, and larger prospective clinical studies are warranted.
引用
收藏
页码:245 / 252
页数:8
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