Oral Progestin Reasonably Effective for Early Endometrial Cancer
(HealthDay News) – 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, MD, PhD, from the University of Ulsan in Korea, and colleagues reviewed the medical records of 48 women (age <40 years) with endometrioid adenocarcinoma of the uterus who were treated conservatively with oral progestin.
The researchers found that 14 patients (29.2%) received daily oral megestrol acetate (median dose, 160mg per day) and 34 patients (70.8%) received daily oral medroxyprogesterone acetate (median dose, 500mg per day). After the median treatment duration of 10 months, 37 patients (77.1%) had complete responses. For patients with stage IA, grade 2–3 without myometrial invasion (17 patients), complete response was 76.5%; for patients with stage IA, grade 1 with superficial myometrial invasion (23), complete response was 73.9%; and for patients with stage IA, grade 2–3 with superficial myometrial invasion (eight), complete response was 87.5%). 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%, 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.