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Clinical outcomes of levonorgestrel-releasing intrauterine device present during controlled ovarian stimulation in patients with early stage endometrioid adenocarcinoma and atypical endometrial hyperplasia after fertility-sparing treatments: 10-year experience in one tertiary hospital in China.
Yin, Jie; Li, Yan; Wang, Hanbi; Wang, Wei; Gu, Yu; Jin, Ying; Deng, Chengyan; Pan, Lingya.
Afiliación
  • Yin J; Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and G
  • Li Y; Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and G
  • Wang H; Gynecological Endocrine and Assisted Reproduction Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, D
  • Wang W; Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and G
  • Gu Y; Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and G
  • Jin Y; Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and G
  • Deng C; Gynecological Endocrine and Assisted Reproduction Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, D
  • Pan L; Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and G
Eur J Obstet Gynecol Reprod Biol ; 280: 83-88, 2023 Jan.
Article en En | MEDLINE | ID: mdl-36436458
BACKGROUND: To evaluate the oncologic and pregnancy outcomes of patients with early stage endometrioid adenocarcinoma (EMC) and atypical endometrial hyperplasia (AEH) treated with controlled ovarian stimulation (COS) with or without levonorgestrel-releasing intrauterine device (LNG-IUD) after fertility-sparing treatment (FSTs). METHODS: A total of 67 patients with EMC or AEH who achieved complete response after FSTs and underwent COS between January 2010 and December 2019 were retrospectively reviewed. Univariate and multivariate Cox regression analyses were used to evaluate the risk factors for recurrence after COS. RESULTS: The average age was 32.9 ± 3.46 years. 23.9 % of these patients relapsed after COS during the follow-up period. The 2-year cumulative recurrence rate was 14.9 % (9.1 % and 20.6 % in the LNG-IUD and control groups, respectively). Compared with the control group, the recurrence rate was lower in patients with LNG-IUDs present during COS (12.1 % vs 35.5 %, p = 0.027). The clinical pregnancy (42.4 % vs 52.9 %, p = 0.392) and live birth (21.2 % vs 29.4 %, p = 0.444) rates were similar between the LNG-IUD and control groups. Age, body mass index (BMI), histology, FST type and time to complete response were not related to prognosis after COS. After adjusting for age and BMI in a multivariate Cox regression model, the use of LNG-IUD during COS was a favorable factor for better oncologic outcomes after COS (HR 0.263, 95 %CI 0.084-0.822, p = 0.022). CONCLUSIONS: Patients with early stage EMC and AEH treated with assisted reproductive technology after FSTs might benefit from LNG-IUDs present during COS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Endometrioide / Hiperplasia Endometrial / Dispositivos Intrauterinos Medicados Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Eur J Obstet Gynecol Reprod Biol Año: 2023 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Endometrioide / Hiperplasia Endometrial / Dispositivos Intrauterinos Medicados Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Eur J Obstet Gynecol Reprod Biol Año: 2023 Tipo del documento: Article Pais de publicación: Irlanda