(HealthDay)—Conservative management with oral progestin can be a reasonable treatment option for many patients with stage 1A endometrial cancer, according to research published in the July issue of Obstetrics & Gynecology.
Jeong-Yeol Park, M.D., Ph.D., from the University of Ulsan in Korea, and colleagues reviewed the medical records of 48 women (age 40 years or younger) with endometrioid adenocarcinoma of the uterus who were treated conservatively with oral progestin.
The researchers found that 14 patients (29.2 percent) received daily oral megestrol acetate (median dose, 160 mg per day) and 34 patients (70.8 percent) received daily oral medroxyprogesterone acetate (median dose, 500 mg per day). After the median treatment duration of 10 months, 37 patients (77.1 percent) had complete responses. For patients with stage IA, grade 2 to 3 without myometrial invasion (17 patients), complete response was 76.5 percent; for patients with stage IA, grade 1 with superficial myometrial invasion (23), complete response was 73.9 percent; and for patients with stage IA, grade 2 to 3 with superficial myometrial invasion (eight), complete response was 87.5 percent). After a median follow-up time of 48 months, recurrence rates for 37 patients who had achieved a complete response were 23.1, 47.1, and 71.4 percent, respectively. No disease progression or death from the disease occurred. Nine patients gave birth to 10 healthy newborns.
"Progestin treatment appears to be reasonably effective for patients with stage IA, grade 2 to 3 differentiation without myometrial invasion and patients with stage IA grade 1 differentiation with superficial myometrial invasion," the authors write.
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