Intrauterine progesterone treatment of early endometrial cancer

被引:163
作者
Montz, FJ
Bristow, RE
Bovicelli, A
Tomacruz, R
Kurman, RJ
机构
[1] Johns Hopkins Hosp & Med Inst, Dept Gynecol & Obstet & Oncol, Kelly Gynecol Oncol Serv, Baltimore, MD 21287 USA
[2] Johns Hopkins Hosp & Med Inst, Dept Pathol, Div Gynecol Pathol, Baltimore, MD USA
关键词
endometrial cancer; hormonal treatment; progesterone-containing intrauterine device;
D O I
10.1067/mob.2002.122130
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Our purpose was to assess the feasibility of using a progesterone-containing intrauterine device (IUD) to treat presumed Federation Internationale Gynecologle et d'Obstetrique (FIGO) stage IA, grade 1 endometrioid cancer in women at high risk for perioperative complications. STUDY DESIGN: Candidates were women with American Society of Anesthesiologists class III or IV grade 1 endometrioid cancer and no imaging evidence of myometrial invasion. Subjects underwent hysteroscopy, curettage, and IUD placement, followed by endometrial biopsy every 3 months for 1 year. The records of similar patients treated surgically during the 3 years before protocol initiation were reviewed for comparison. RESULTS: Sixteen patients fulfilled study criteria. Fourteen consented to participation; one was excluded at the time of IUD placement (grade 2 disease identified) and one was lost to follow-up, Twelve subjects have been followed up to 36 months; results of biopsies were negative In 7 of 11 at 6 months and 6 of 8 at 12 months. No IUD-related complications, except for expulsion, occurred. Sixteen complications (one fatal) occurred in 9 of the 15 control patients. CONCLUSION: Intrauterine progesterone appears to eradicate some cases of presumed stage IA, grade 1 endometrioid cancer in women at high risk for perioperative morbidity.
引用
收藏
页码:651 / 657
页数:7
相关论文
共 27 条
[1]  
[Anonymous], 1994, BLAUSTEINS PATHOLOGY, DOI [DOI 10.1007/978-1-4757-3889-6_12, 10.1007/978-1-4757-3889-6_12]
[2]   Transdermal estrogen with a levonorgestrel-releasing intrauterine device for climacteric complaints versus estradiol-releasing vaginal ring with a vaginal progesterone suppository: Clinical and endometrial responses [J].
Antoniou, G ;
Kalogirou, D ;
Karakitsos, P ;
Antoniou, D ;
Kalogirou, O .
MATURITAS, 1997, 26 (02) :103-111
[3]   2 PATHOGENETIC TYPES OF ENDOMETRIAL CARCINOMA [J].
BOKHMAN, JV .
GYNECOLOGIC ONCOLOGY, 1983, 15 (01) :10-17
[4]   CAN PRIMARY ENDOMETRIAL CARCINOMA STAGE-I BE CURED WITHOUT SURGERY AND RADIATION-THERAPY [J].
BOKHMAN, JV ;
CHEPICK, OF ;
VOLKOVA, AT ;
VISHNEVSKY, AS .
GYNECOLOGIC ONCOLOGY, 1985, 20 (02) :139-155
[5]  
CREASMAN W, 1998, J EPIDEMIOL BIOSTAT, V3, P35
[6]   Levonorgestrel-releasing intrauterine device versus hysteroscopic endometrial resection in the treatment of dysfunctional uterine bleeding [J].
Crosignani, PG ;
Vercellini, P ;
Mosconi, P ;
Oldani, S ;
Cortesi, I ;
DeGiorgi, O .
OBSTETRICS AND GYNECOLOGY, 1997, 90 (02) :257-263
[7]   DISTRIBUTION AND EFFECT ON THE ENDOMETRIUM OF PROGESTERONE RELEASED FROM A PROGESTASERT DEVICE [J].
ERMINI, M ;
CARPINO, F ;
PETROZZA, V ;
BENAGIANO, G .
HUMAN REPRODUCTION, 1989, 4 (03) :221-228
[8]   Levonorgestrel-releasing intrauterine device for the treatment of menometrorrhagia in a woman on hemodialysis [J].
Fedele, L ;
Gammaro, L ;
Bianchi, S .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (07) :541-541
[9]   MULTICENTER STUDY OF GENERAL-ANESTHESIA .3. PREDICTORS OF SEVERE PERIOPERATIVE ADVERSE OUTCOMES [J].
FORREST, JB ;
REHDER, K ;
CAHALAN, MK ;
GOLDSMITH, CH .
ANESTHESIOLOGY, 1992, 76 (01) :3-15
[10]   Cancer statistics, 2000 [J].
Greenlee, RT ;
Murray, T ;
Bolden, S ;
Wingo, PA .
CA-A CANCER JOURNAL FOR CLINICIANS, 2000, 50 (01) :7-33