Fertility-sparing treatment of atypical endometrial hyperplasia and stage IA,well-differentiated endometrial carcinoma:A retrospective study
Objective:The present study investigated long-term outcomes of conservative treatment of atypical endometrial hyperplasia(AEH)and endometrial carcinoma(EC),and post-treatment conception.Methods:Atotal of 96 patients who received conservative treatment in the First Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Xinxiang medical College from January 2010 to May 2022 were selected as the research objects,Complete response rate(CR),Partial response rate(PR),Recurrence rate(RR)and pregnancy outcomes of EC and AEH groups were analyzed.Results:A total of 96 patients were included in the analysis,including 33 patients in the EC group and 63 patients in the AEH group.At the evaluation of 9 months of treatment,the CR rate of the EC group was 78.8％(26/33)and the CR rate of the AEH group was 82.5％(52/63),with no statistical significance between the two groups(P＞0.05),and the complete response rate of the two groups reached 83.3％.The mean time to Partial response in EC and AEH groups was(3.54±1.76)months and(3.18±1.50)months,respectively,and the mean time to complete remission was(5.71±2.40)months and(5.39±2.65)months,respectively,there was no significant difference between the two groups(P＞0.05).The recurrence rate of EC group was 30.7％,and the mean recurrence time was(21.11±11.00)months.The recurrence rate of AEH group was 26.5％,and the mean recurrence time was 33.23±14.96 months.The overall recurrence rate of the two groups was 26.9％.The mean recurrence time was(28.61±14.59)months.There was no statistical significance in recurrence rate between the two groups(P＞0.05).A total of 58(74.3％)patients in the two groups wanted immediate pregnancy after treatment,and the final successful pregnancy rate was 39.6％,with a live birth rate of 78.2％.Conclusion:EC and AEH can achieve high remission rate and pregnancy rate by using high-effective progestogen-based conservation therapy,which can save time for the patients with infertility,but the recurrence rate is high.Operation should be performed as soon as possible after pregnancy is completed.
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