Fertility sparing approach in young women with endometrial cancer

Czech version

Authors: Z. Hejl ¹ ; J. Hanáček ² ; R. Pilka ³
Authors‘ workplace: Gynekologicko-porodnické oddělení, Nemocnice Šumperk a. s. ¹; Ústav pro péči o matku a dítě, Praha ²; Porodnicko-gynekologická klinika LF UP a FN Olomouc ³
Published in: Ceska Gynekol 2022; 87(3): 202-205
Category: Review Article
doi: https://doi.org/10.48095/cccg2022202

Overview

The incidence of endometrial cancer in young women is increasing, especially in developed countries. Although it is predominantly a disease of peri- and postmenopausal women, there is an absolute increase in younger women of childbearing age who, with today's lifestyle and pushing back maternal needs, do not have fulfilled reproductive plans. About 67% of cancers are diagnosed in the early stages. For these women, fertility-preserving procedures can be considered until reproductive plans are fulfilled. Subsequently, however, definitive management is appropriate even in the absence of carcinoma. This article discusses the most common gynecologic pelvic cancer, endometrial adenocarcinoma, and the possibility of fertility-preserving procedures.

Keywords:

endometrial cancer – young woman – fertility sparing

Sources

1. Aimagambetova G, Terzic S, Simone Laganà A et al. Contemporary fertility-sparing management options of early stage endometrioid endometrial cancer in young nulliparous patients. J Clin Med 2022; 11(1): 196. doi: 10.3390/ jcm 11010196.

2. Matsuo K, Mandelbaum RS, Matsuzaki S et al. Ovarian conservation for young women with early-stage, low-grade endometrial cancer: a 2 – step schema. Am J Obstet Gynecol 2021; 224(6): 574–584. doi: 10.1016/ j.ajog.2020.12.1213.

3. Weinberger V, Vinklerová P. Operační léčba karcinomu edometria. Moderní gynekologie a porodnictví 2020; 27(3): 223–231.

4. Lucchini SM, Esteban A, Nigra MA et al. Updates on conservative management of endometrial cancer in patients younger than 45 years. Gynecol Oncol 2021; 161(3): 802–809. doi: 10.1016/ j.ygyno.2021.04.017.

5. Minář L. Fertilitu zachovávající terapie gynekologických malignit. Ceska Gynekol 2009; 74(6): 420–427.

6. Gompel A. Progesterone and endometrial cancer. Best Pract Res Clin Obstet Gynaecol 2020; 69: 95–107. doi: 10.1016/ j.bpobgyn.2020.05.003.

7. Greenwald ZR, Huang LN, Wissing MD et al. Does hormonal therapy for fertility preservation affect the survival of young women with earlystage endometrial cancer? Cancer 2017; 123(9): 1545–1554. doi: 10.1002/ cncr.30529.

8. Emons G, Gründker C. The role of gonadotropin- releasing hormone (GnRH) in endometrial cancer. Cells 2021; 10(2): 292. doi: 10.3390/ cells10020292.

9. Alonso S, Castellanos T, Lapuente F et al. Hysteroscopic surgery for conservative management in endometrial cancer: a review of the literature. Ecancermedicalscience 2015; 9: 505. doi: 10.3332/ ecancer.2015.505.

10. Vaugon M, Peigné M, Phelippeau J et al. IVF impact on the risk of recurrence of endometrial adenocarcinoma after fertility-sparing management. Reprod Biomed Online 2021; 43(3): 495–502. doi: 10.1016/ j.rbmo.2021.06.007.

11. Azim A, Oktay K. Letrozole for ovulation induction and fertility preservation by embryo cryopreservation in young women with endometrial carcinoma. Fertil Steril 2007; 88(3): 657–664. doi: 10.1016/ j.fertnstert.2006.12.068.

12. Lavery S, Ng C, Kyrgiou M et al. Gestational surrogacy after intra-operative oocyte collection in a hysterectomised woman diagnosed with endometrial cancer. BJOG 2011; 118(13): 1669–1671. doi: 10.1111/ j.1471-0528.2011.03145.x.

13. Roberts J, Ronn R, Tallon N et al. Fertility preservation in reproductive-age women facing gonadotoxic treatments. Curr Oncol 2015; 22(4). e294–e304. doi: 10.3747/ co.22.2334.

14. Chae SH, Shim SH, Lee SJ et al. Pregnancy and oncologic outcomes after fertility-sparing management for early stage endometrioid endometrial cancer. Int J Gynecol Cancer 2019; 29; 77–85. doi: 10.1136/ ijgc-2018.000036.

15. Concin N, Matias-Guiu X, Vergote I et al. ESGO/ ESTRO/ ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer 2021; 31(1): 12–39. doi: 10.1136/ ijgc-2020-002230.