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Fertility-sparing treatment using medroxyprogesterone acetate for endometrial carcinoma.
MedLine Citation:
PMID:  22783380     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The purpose of this study was to present the results of fertility-sparing treatment using medroxyprogesterone acetate (MPA) for endometrial carcinoma (EC), and to clarify patient characteristics by investigating patient background factors. A total of 59 patients with EC, who received MPA as fertility-sparing therapy at two institutions over a 21-year period between 1987 and 2008, were studied retrospectively. Patients were administered oral MPA at 400-600 mg/day for 16-24 weeks as long as they responded. Endometrial tissue was assessed twice, at 8-12 weeks (during treatment) and shortly after treatment. The overall complete response (CR) rate was 71%. A total of 22 (52%) of 42 responders later developed relapse. A total of 19 cases became pregnant, and 25 infants were born. Eighty percent of recurrences occurred within 2 years. For stages I a and I b- II a (FIGO, 1988), initial CR rates were 80.0 and 42.9%, respectively (p<0.01), demonstrating a significant difference. Total hysterectomy was performed for 26 patients (44%) due to recurrence or failure to respond to the initial treatment. Among these 26 patients, postoperative stages were more advanced in 10 patients (38%). The grade advanced (became more poorly differentiated) postoperatively in 2 patients (8%). Premenopausal females with EC can be treated successfully with MPA, however patients should be informed of the risks and limitations of this conservative treatment.
Authors:
Hiroyuki Fujiwara; Toshiko Jobo; Yuji Takei; Yasushi Saga; Manami Imai; Tsutomu Arai; Akiyo Taneichi; Shizuo Machida; Yoshifumi Takahashi; Mitsuaki Suzuki
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-10
Journal Detail:
Title:  Oncology letters     Volume:  3     ISSN:  1792-1082     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-7-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101531236     Medline TA:  Oncol Lett     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1002-1006     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan.
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