Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer

Obstet Gynecol. 2003 Oct;102(4):718-25. doi: 10.1016/s0029-7844(03)00667-7.


Objective: To evaluate the safety of fertility-sparing hormonal therapy for endometrial cancer in young patients.

Methods: We reviewed the clinical and pathologic records of patients diagnosed with endometrial adenocarcinoma before the age of 40, who were treated and followed over a 30-year period in the Division of Gynecologic Oncology. All patients who underwent conservative management with progestins (n = 13) are the subjects of this study.

Results: Follow-up was available for all 13 patients, with a mean follow-up of 82 months. All patients responded to treatment within a mean period of 3.5 months, with normal pathology on follow-up endometrial samplings. Six patients had a recurrence within a period extending between 19 and 358 months (median 40 months). Four patients were treated with a second course of progestins, and all had a histologic complete response. As of the time of preparation of this report, nine healthy infants had been born, and all the patients remained without evidence of disease.

Conclusion: Conservative management of well-differentiated endometrial carcinoma in young patients, combined with assisted reproductive technologies, if needed, does not seem to worsen the prognosis. This approach also provides the possibility of conceiving and carrying a normal pregnancy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / etiology
  • Adenocarcinoma / pathology
  • Adult
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / epidemiology
  • Endometrial Neoplasms / etiology
  • Endometrial Neoplasms / pathology
  • Female
  • Fertilization in Vitro
  • Humans
  • Hysterectomy
  • Israel / epidemiology
  • Medical Records
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Recurrence, Local / pathology
  • Pregnancy
  • Pregnancy Outcome
  • Progestins / therapeutic use*
  • Remission Induction
  • Retrospective Studies
  • Treatment Outcome


  • Progestins