Fertility Sparing in Endometrial Cancer : Where Are We Now?
Centini, G. (University of Siena)
Colombi, I. (University of Siena)
Ianes, I. (University of Siena)
Perelli, F. (Meyer Children's Hospital IRCCS)
Ginetti, A. (University of Siena)
Cannoni, A. (University of Siena)
Habib, Nassir (Clinique de l'Yvette)
Rovira Negre, Ramon (Institut de Recerca Sant Pau)
Martire, F.G. (University of Siena)
Raimondo, D. (IRCCS Azienda Ospedaliero Univeristaria di Bologna)
Lazzeri, L. (University of Siena)
Zupi, E. (University of Siena)
Universitat Autònoma de Barcelona

Data:	2025
Resum:	Endometrial cancer is the most common gynecological neoplasm with an increased incidence in the premenopausal population in recent decades. This raises the problem of managing endometrial cancer in fertile women who have not yet achieved pregnancy. In these women, after careful selection, hysterectomy may be postponed in favor of conservative management if specific requirements are met. The latest evidence is focused on early endometrial carcinoma, endometrioid histotype, Grading 1, with no evidence of myometrial infiltration. Few clinical trials have opened this possibility also for women with an endometrial cancer Grading 2 diagnosis. There are still questions about the best medical therapy, dosage, route, and duration of treatment. Oral progestins or levonorgestrel-releasing intrauterine devices appear to be the options associated with the best outcome in terms of complete response and lower recurrence rates. Other options include the use of GnRH analogues, surgical hysteroscopy, or metformin, in a therapeutic approach that takes into account the characteristics of the patient. The pursuit of pregnancy should start as soon as two consecutive endometrial biopsies are obtained 3 months apart from each other; it is recommended to refer the patients to ART centers to maximize the success rate. After having reached the fulfillment of the reproductive desire, surgical radical treatment is still recommended.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Endometrial cancer ; Fertility sparing ; Uterine neoplasms
Publicat a:	Cancers, Vol. 17 Núm. 1 (january 2025) , p. 112, ISSN 2072-6694

DOI: 10.3390/cancers17010112
PMID: 39796739

17 p, 1.3 MB

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