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- Title
Characteristics of progestininsensitive early stage endometrial cancer and atypical hyperplasia patients receiving second-line fertility-sparing treatment.
- Authors
Shuang Zhou; Zhiying Xu; Bingyi Yang; Jun Guan; Weiwei Shan; Yue Shi; Xiaojun Chen
- Abstract
Objective: This study investigated the characteristics of progestin-insensitive endometrioid endometrial cancer (EEC) and atypical endometrial hyperplasia (AEH) patients receiving fertility-sparing treatments and assessed the therapeutic effects of second-line fertilitypreserving treatments. Methods: Three hundred and thirty-eight patients with EEC (n=75) or AEH (n=263) receiving fertility-preserving treatment were retrospectively analyzed. 'Progestin-insensitive' was defined as meeting one of the following criteria: 1) presented with progressed disease at any time during conservative treatment, 2) remained with stable disease after 7 months of treatment, and/or 3) did not achieve complete response (CR) after 10 months of treatment. Clinical characteristics and treatment results of progestin-insensitive patients receiving second-line treatment and those of progestin-sensitive patients were compared. Results: Eight-two patients (59 AEH and 23 EEC) were defined as progestin-insensitive and 256 as progestin-sensitive. In multivariate analysis, body mass index =28.0 kg/m2 (odds ratio [OR]=1.898) and lesion size >2 cm (OR=2.077) were independent predictors of progestininsensitive status. Compared to AEH patients, progestin-insensitive EEC patients had poorer second-line treatment responses (28-week cumulative CR rate after changing second-line treatment, 56.3% vs. 85.4%, p=0.011). No statistical difference was found in CR rate among different second-line treatments. Conclusion: Obesity and larger lesion size were independent risk factors associated with progestin-insensitive status. In progestin-insensitive patients receiving second-line treatment, EEC patients had lower CR rate comparing with AEH patients. Further study with larger sample size is needed to evaluate efficacy of different second-line treatments for progestin insensitive patients.
- Subjects
ENDOMETRIAL hyperplasia; CONSERVATIVE treatment; BODY mass index; TUMOR classification; ENDOMETRIAL cancer; TREATMENT effectiveness
- Publication
Journal of Gynecologic Oncology, 2021, Vol 32, Issue 4, p1
- ISSN
2005-0380
- Publication type
Article
- DOI
10.3802/jgo.2021.32.e57