Fertility-sparing treatment using medroxyprogesterone acetate for endometrial carcinoma

Fujiwara,Hiroyuki; Jobo,Toshiko; Takei,Yuji; Saga,Yasushi; Imai,Manami; Arai,Tsutomu; Taneichi,Akiyo; Machida,Shizuo; Takahashi,Yoshifumi; Suzuki,Mitsuaki

doi:10.3892/ol.2012.602

Fertility-sparing treatment using medroxyprogesterone acetate for endometrial carcinoma

Authors:
- Hiroyuki Fujiwara
- Toshiko Jobo
- Yuji Takei
- Yasushi Saga
- Manami Imai
- Tsutomu Arai
- Akiyo Taneichi
- Shizuo Machida
- Yoshifumi Takahashi
- Mitsuaki Suzuki
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Affiliations: Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan, Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Kanagawa 252‑0374, Japan
Published online on: February 10, 2012 https://doi.org/10.3892/ol.2012.602
Pages: 1002-1006

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Abstract

The purpose of this study was to present the results of fertility-sparing treatment using medroxyprogesterone acetate (MPA) for endometrial carcinoma (EC), and to clarify patient characteristics by investigating patient background factors. A total of 59 patients with EC, who received MPA as fertility‑sparing therapy at two institutions over a 21-year period between 1987 and 2008, were studied retrospectively. Patients were administered oral MPA at 400-600 mg/day for 16-24 weeks as long as they responded. Endometrial tissue was assessed twice, at 8-12 weeks (during treatment) and shortly after treatment. The overall complete response (CR) rate was 71%. A total of 22 (52%) of 42 responders later developed relapse. A total of 19 cases became pregnant, and 25 infants were born. Eighty percent of recurrences occurred within 2 years. For stages Ⅰa and Ⅰb-Ⅱa (FIGO, 1988), initial CR rates were 80.0 and 42.9%, respectively (p<0.01), demonstrating a significant difference. Total hysterectomy was performed for 26 patients (44%) due to recurrence or failure to respond to the initial treatment. Among these 26 patients, postoperative stages were more advanced in 10 patients (38%). The grade advanced (became more poorly differentiated) postoperatively in 2 patients (8%). Premenopausal females with EC can be treated successfully with MPA, however patients should be informed of the risks and limitations of this conservative treatment.

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