Effectiveness of high-dose progestin and long-term outcomes in young women with early-stage, well-differentiated endometrioid adenocarcinoma of uterine endometrium

Arch Gynecol Obstet. 2012 Feb;285(2):473-8. doi: 10.1007/s00404-011-1959-x. Epub 2011 Jun 25.


Purpose: We assessed the effectiveness of high-dose progestins as a conservative treatment in young women with endometrial adenocarcinoma.

Methods: We retrospectively reviewed the hospital data of patients with endometrial cancer that were managed conservatively. Of those women with grade 1 endometrioid endometrial adenocarcinoma, we included those who were younger than 40 years and in whom the disease was clinically confined to the endometrium. A complete response was defined pathologically as the absence of tissue with adenocarcinoma or hyperplasia.

Results: Fourteen patients were included. Their mean age was 30.0 ± 4.8 years and the mean follow-up period was 47.3 ± 29.7 months. Twelve patients received 30-500 mg/day medroxyprogesterone acetate and two received 160 or 240 mg/day megestrol acetate. The median duration of treatment was 6 months (range 3-15 months) and 13 (93%) patients showed a complete response. Endometrial pathology reappeared in four patients (4/13, 31%) including two relapses, three of whom developed after the patients gave birth. Six patients used a combined oral contraceptive or a progestin-releasing intrauterine device as a maintenance therapy and experienced no recurrence. Four women (4/7, 57%) conceived successfully seven times with assisted-reproductive technology. No adverse effects of the progestins or tumor-related death were noted.

Conclusions: High-dose progestin therapy can be an effective conservative treatment in young patients with well-differentiated early-stage endometrial cancer. If patients wish to preserve their fertility even after they have completed childbearing, maintenance therapy with a cyclic oral contraceptive or a progestin-releasing intrauterine device may be an option to prevent recurrence.

MeSH terms

  • Adult
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Carcinoma, Endometrioid / drug therapy*
  • Carcinoma, Endometrioid / pathology
  • Contraceptives, Oral, Hormonal / therapeutic use
  • Female
  • Fertility Preservation
  • Follow-Up Studies
  • Humans
  • Intrauterine Devices, Medicated
  • Maintenance Chemotherapy
  • Medroxyprogesterone Acetate / administration & dosage*
  • Medroxyprogesterone Acetate / therapeutic use
  • Megestrol Acetate / administration & dosage*
  • Megestrol Acetate / therapeutic use
  • Neoplasm Recurrence, Local / drug therapy*
  • Retrospective Studies
  • Time Factors
  • Uterine Neoplasms / drug therapy*
  • Uterine Neoplasms / pathology
  • Young Adult


  • Antineoplastic Agents, Hormonal
  • Contraceptives, Oral, Hormonal
  • Medroxyprogesterone Acetate
  • Megestrol Acetate