Prolonged conservative treatment in patients with recurrent endometrial cancer after primary fertility-sparing therapy: 15-year experience
Objective To evaluate the efficacy and prognosis of repeated treatment on patients with recurrent endometrial cancer (EC) after complete remission for primary fertility-preserving therapy. Materials and methods We performed a retrospective study of patients with presumed stage IA endometrial cancer...
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| Veröffentlicht in: | International journal of clinical oncology 2019-06, Vol.24 (6), p.712-720 |
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| container_title | International journal of clinical oncology |
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| creator | Wang, Yao Yu, Mei Yang, Jia-xin Cao, Dong-yan Yuan, Zhen Zhou, Hui-mei Zhang, Ying Li, Lei Shen, Keng Wu, Huanwen |
| description | Objective
To evaluate the efficacy and prognosis of repeated treatment on patients with recurrent endometrial cancer (EC) after complete remission for primary fertility-preserving therapy.
Materials and methods
We performed a retrospective study of patients with presumed stage IA endometrial cancer who had recurrence after achieving complete remission by fertility-preserving management at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2003 to April 2018. For each patient, medical records and pathology reports were reviewed. The demographic features, treatment efficacy, tumor prognosis, and reproductive outcome were analyzed.
Results
Of the 41 recurrent patients with a median disease-free interval period of 16 months (range, 5–55 months), 23 were diagnosed at recurrence as EC, and 18 were diagnosed as atypical hyperplasia (AH) or endometrial intraepithelial neoplasia (EIN). 26 patients received repeated fertility-preserving treatment, and 23 patients were evaluable for efficacy. The complete response (CR) rate of repeated treatment (19/23, 82.6%) was lower than that of primary fertility-preserving treatment (161/170, 94.7%) with borderline significance (
P
= 0.053). The CR rate of AH/EIN patients was higher than that of EC patients with no statistical difference (92.9% vs 66.7%,
P
= 0.260). Among 19 patients achieved CR, 3 got pregnant and delivered successfully, while 3 had a second relapse. Four cases failed to response to the repeated treatment and underwent definitive surgery. 15 patients referred to definitive surgery directly after recurrence and one of them had a pelvic recurrence after 120 months. All patients are alive without evidence of disease at last follow-up.
Conclusions
For patients with recurrent EC after primary fertility-preserving treatment, repeated fertility-preserving treatment can still achieve a promising response and patients have possibilities of completing childbirth. |
| doi_str_mv | 10.1007/s10147-019-01404-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2229084323</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2178455295</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-2ef28fb8f5336f439bbeccb46eec79783e511df6733277813e6e8e35f9b4f8403</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS1ERELgB1ggS2zYmPjZbrNDEQlIkcIC1pbbU0466hdld8L8Al8dDzOAxIKF7VL51K2yLyGvBH8nOLdnWXChLePC1aW5ZvIJORFaWWatlU9rrLRgrpHmmDzP-Y5zYRsjn5Fjxa1ujDMn5OcXnId5uoENjfOUAe9D6e-BFoRQRpgK7Se61FwNM33oyy1FiCvi7gqmzTxCwT4MNIYpAtKQSt0X7MeAW5oASz_0ZcvyErCfbmi5BQzL9j0Vhm0hIIUfC2BVj_CCHKUwZHh5OE_Jt4uPX88_savry8_nH65YVM4VJiHJNnVtMko1SSvXdRBjpxuAaJ1tFRghNqmxSklrW6GggRaUSa7TqdVcnZK3e90F5-8r5OLHPkcYhjDBvGYvpXS81Uqqir75B72bV5zqdF4K22pjpDOVknsq4pwzQvKH93vB_c4pv3fKV6f8L6e8rEWvD9JrN8LmT8lvayqg9kBedj8H-Lf3f2QfAbFZoW4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2178455295</pqid></control><display><type>article</type><title>Prolonged conservative treatment in patients with recurrent endometrial cancer after primary fertility-sparing therapy: 15-year experience</title><source>SpringerLink</source><creator>Wang, Yao ; Yu, Mei ; Yang, Jia-xin ; Cao, Dong-yan ; Yuan, Zhen ; Zhou, Hui-mei ; Zhang, Ying ; Li, Lei ; Shen, Keng ; Wu, Huanwen</creator><creatorcontrib>Wang, Yao ; Yu, Mei ; Yang, Jia-xin ; Cao, Dong-yan ; Yuan, Zhen ; Zhou, Hui-mei ; Zhang, Ying ; Li, Lei ; Shen, Keng ; Wu, Huanwen</creatorcontrib><description>Objective
To evaluate the efficacy and prognosis of repeated treatment on patients with recurrent endometrial cancer (EC) after complete remission for primary fertility-preserving therapy.
Materials and methods
We performed a retrospective study of patients with presumed stage IA endometrial cancer who had recurrence after achieving complete remission by fertility-preserving management at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2003 to April 2018. For each patient, medical records and pathology reports were reviewed. The demographic features, treatment efficacy, tumor prognosis, and reproductive outcome were analyzed.
Results
Of the 41 recurrent patients with a median disease-free interval period of 16 months (range, 5–55 months), 23 were diagnosed at recurrence as EC, and 18 were diagnosed as atypical hyperplasia (AH) or endometrial intraepithelial neoplasia (EIN). 26 patients received repeated fertility-preserving treatment, and 23 patients were evaluable for efficacy. The complete response (CR) rate of repeated treatment (19/23, 82.6%) was lower than that of primary fertility-preserving treatment (161/170, 94.7%) with borderline significance (
P
= 0.053). The CR rate of AH/EIN patients was higher than that of EC patients with no statistical difference (92.9% vs 66.7%,
P
= 0.260). Among 19 patients achieved CR, 3 got pregnant and delivered successfully, while 3 had a second relapse. Four cases failed to response to the repeated treatment and underwent definitive surgery. 15 patients referred to definitive surgery directly after recurrence and one of them had a pelvic recurrence after 120 months. All patients are alive without evidence of disease at last follow-up.
Conclusions
For patients with recurrent EC after primary fertility-preserving treatment, repeated fertility-preserving treatment can still achieve a promising response and patients have possibilities of completing childbirth.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-019-01404-2</identifier><identifier>PMID: 30746595</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Cancer ; Cancer Research ; Endometrial cancer ; Endometrium ; Fertility ; Gynecology ; Hyperplasia ; Medical records ; Medicine ; Medicine & Public Health ; Obstetrics ; Oncology ; Original Article ; Patients ; Prognosis ; Remission ; Surgery ; Surgical Oncology</subject><ispartof>International journal of clinical oncology, 2019-06, Vol.24 (6), p.712-720</ispartof><rights>Japan Society of Clinical Oncology 2019</rights><rights>International Journal of Clinical Oncology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-2ef28fb8f5336f439bbeccb46eec79783e511df6733277813e6e8e35f9b4f8403</citedby><cites>FETCH-LOGICAL-c399t-2ef28fb8f5336f439bbeccb46eec79783e511df6733277813e6e8e35f9b4f8403</cites><orcidid>0000-0003-4001-1188</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10147-019-01404-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10147-019-01404-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30746595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Yao</creatorcontrib><creatorcontrib>Yu, Mei</creatorcontrib><creatorcontrib>Yang, Jia-xin</creatorcontrib><creatorcontrib>Cao, Dong-yan</creatorcontrib><creatorcontrib>Yuan, Zhen</creatorcontrib><creatorcontrib>Zhou, Hui-mei</creatorcontrib><creatorcontrib>Zhang, Ying</creatorcontrib><creatorcontrib>Li, Lei</creatorcontrib><creatorcontrib>Shen, Keng</creatorcontrib><creatorcontrib>Wu, Huanwen</creatorcontrib><title>Prolonged conservative treatment in patients with recurrent endometrial cancer after primary fertility-sparing therapy: 15-year experience</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>Objective
To evaluate the efficacy and prognosis of repeated treatment on patients with recurrent endometrial cancer (EC) after complete remission for primary fertility-preserving therapy.
Materials and methods
We performed a retrospective study of patients with presumed stage IA endometrial cancer who had recurrence after achieving complete remission by fertility-preserving management at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2003 to April 2018. For each patient, medical records and pathology reports were reviewed. The demographic features, treatment efficacy, tumor prognosis, and reproductive outcome were analyzed.
Results
Of the 41 recurrent patients with a median disease-free interval period of 16 months (range, 5–55 months), 23 were diagnosed at recurrence as EC, and 18 were diagnosed as atypical hyperplasia (AH) or endometrial intraepithelial neoplasia (EIN). 26 patients received repeated fertility-preserving treatment, and 23 patients were evaluable for efficacy. The complete response (CR) rate of repeated treatment (19/23, 82.6%) was lower than that of primary fertility-preserving treatment (161/170, 94.7%) with borderline significance (
P
= 0.053). The CR rate of AH/EIN patients was higher than that of EC patients with no statistical difference (92.9% vs 66.7%,
P
= 0.260). Among 19 patients achieved CR, 3 got pregnant and delivered successfully, while 3 had a second relapse. Four cases failed to response to the repeated treatment and underwent definitive surgery. 15 patients referred to definitive surgery directly after recurrence and one of them had a pelvic recurrence after 120 months. All patients are alive without evidence of disease at last follow-up.
Conclusions
For patients with recurrent EC after primary fertility-preserving treatment, repeated fertility-preserving treatment can still achieve a promising response and patients have possibilities of completing childbirth.</description><subject>Cancer</subject><subject>Cancer Research</subject><subject>Endometrial cancer</subject><subject>Endometrium</subject><subject>Fertility</subject><subject>Gynecology</subject><subject>Hyperplasia</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Obstetrics</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Remission</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kctuFDEQRS1ERELgB1ggS2zYmPjZbrNDEQlIkcIC1pbbU0466hdld8L8Al8dDzOAxIKF7VL51K2yLyGvBH8nOLdnWXChLePC1aW5ZvIJORFaWWatlU9rrLRgrpHmmDzP-Y5zYRsjn5Fjxa1ujDMn5OcXnId5uoENjfOUAe9D6e-BFoRQRpgK7Se61FwNM33oyy1FiCvi7gqmzTxCwT4MNIYpAtKQSt0X7MeAW5oASz_0ZcvyErCfbmi5BQzL9j0Vhm0hIIUfC2BVj_CCHKUwZHh5OE_Jt4uPX88_savry8_nH65YVM4VJiHJNnVtMko1SSvXdRBjpxuAaJ1tFRghNqmxSklrW6GggRaUSa7TqdVcnZK3e90F5-8r5OLHPkcYhjDBvGYvpXS81Uqqir75B72bV5zqdF4K22pjpDOVknsq4pwzQvKH93vB_c4pv3fKV6f8L6e8rEWvD9JrN8LmT8lvayqg9kBedj8H-Lf3f2QfAbFZoW4</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Wang, Yao</creator><creator>Yu, Mei</creator><creator>Yang, Jia-xin</creator><creator>Cao, Dong-yan</creator><creator>Yuan, Zhen</creator><creator>Zhou, Hui-mei</creator><creator>Zhang, Ying</creator><creator>Li, Lei</creator><creator>Shen, Keng</creator><creator>Wu, Huanwen</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4001-1188</orcidid></search><sort><creationdate>20190601</creationdate><title>Prolonged conservative treatment in patients with recurrent endometrial cancer after primary fertility-sparing therapy: 15-year experience</title><author>Wang, Yao ; Yu, Mei ; Yang, Jia-xin ; Cao, Dong-yan ; Yuan, Zhen ; Zhou, Hui-mei ; Zhang, Ying ; Li, Lei ; Shen, Keng ; Wu, Huanwen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-2ef28fb8f5336f439bbeccb46eec79783e511df6733277813e6e8e35f9b4f8403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Cancer</topic><topic>Cancer Research</topic><topic>Endometrial cancer</topic><topic>Endometrium</topic><topic>Fertility</topic><topic>Gynecology</topic><topic>Hyperplasia</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Obstetrics</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Remission</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Yao</creatorcontrib><creatorcontrib>Yu, Mei</creatorcontrib><creatorcontrib>Yang, Jia-xin</creatorcontrib><creatorcontrib>Cao, Dong-yan</creatorcontrib><creatorcontrib>Yuan, Zhen</creatorcontrib><creatorcontrib>Zhou, Hui-mei</creatorcontrib><creatorcontrib>Zhang, Ying</creatorcontrib><creatorcontrib>Li, Lei</creatorcontrib><creatorcontrib>Shen, Keng</creatorcontrib><creatorcontrib>Wu, Huanwen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Yao</au><au>Yu, Mei</au><au>Yang, Jia-xin</au><au>Cao, Dong-yan</au><au>Yuan, Zhen</au><au>Zhou, Hui-mei</au><au>Zhang, Ying</au><au>Li, Lei</au><au>Shen, Keng</au><au>Wu, Huanwen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prolonged conservative treatment in patients with recurrent endometrial cancer after primary fertility-sparing therapy: 15-year experience</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>24</volume><issue>6</issue><spage>712</spage><epage>720</epage><pages>712-720</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>Objective
To evaluate the efficacy and prognosis of repeated treatment on patients with recurrent endometrial cancer (EC) after complete remission for primary fertility-preserving therapy.
Materials and methods
We performed a retrospective study of patients with presumed stage IA endometrial cancer who had recurrence after achieving complete remission by fertility-preserving management at the Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, from January 2003 to April 2018. For each patient, medical records and pathology reports were reviewed. The demographic features, treatment efficacy, tumor prognosis, and reproductive outcome were analyzed.
Results
Of the 41 recurrent patients with a median disease-free interval period of 16 months (range, 5–55 months), 23 were diagnosed at recurrence as EC, and 18 were diagnosed as atypical hyperplasia (AH) or endometrial intraepithelial neoplasia (EIN). 26 patients received repeated fertility-preserving treatment, and 23 patients were evaluable for efficacy. The complete response (CR) rate of repeated treatment (19/23, 82.6%) was lower than that of primary fertility-preserving treatment (161/170, 94.7%) with borderline significance (
P
= 0.053). The CR rate of AH/EIN patients was higher than that of EC patients with no statistical difference (92.9% vs 66.7%,
P
= 0.260). Among 19 patients achieved CR, 3 got pregnant and delivered successfully, while 3 had a second relapse. Four cases failed to response to the repeated treatment and underwent definitive surgery. 15 patients referred to definitive surgery directly after recurrence and one of them had a pelvic recurrence after 120 months. All patients are alive without evidence of disease at last follow-up.
Conclusions
For patients with recurrent EC after primary fertility-preserving treatment, repeated fertility-preserving treatment can still achieve a promising response and patients have possibilities of completing childbirth.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>30746595</pmid><doi>10.1007/s10147-019-01404-2</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4001-1188</orcidid></addata></record> |
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| subjects | Cancer Cancer Research Endometrial cancer Endometrium Fertility Gynecology Hyperplasia Medical records Medicine Medicine & Public Health Obstetrics Oncology Original Article Patients Prognosis Remission Surgery Surgical Oncology |
| title | Prolonged conservative treatment in patients with recurrent endometrial cancer after primary fertility-sparing therapy: 15-year experience |
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