Clinical analysis of 8 cases of fertility preservation treatment of early endometrial cancer with ovarian malignant tumor
Objective To investigate the clinicopathological characteristics and treatment outcomes of early-stage endometrial cancer(EC)with ovarian malignant tumor.Methods Retrospectively analyzed the clinical data,diagnosis and treatment outcomes of 8 cases of EC with borderline and malignant ovarian tumors confirmed by histopathology in Peking University People's Hospital from January 2016 to February 2023.Results ① All 8 cases were pathologically diagnosed as endometrioid adenocarcinoma,including 5 cases of G1 and 3 cases of G2.Pelvic magnetic resonance imaging(MRI)showed no deep myometrial invasion(4 cases of superficial myometrial invasion).There were 6 cases of EC with ovarian cancer,the pathological type of ovarian cancer was ovarian endometrioid carcinoma,and 2 cases of ovarian borderline tumor.All ovarian masses were unilateral,including 7 cases in the right ovary and 1 case in the left ovary.② Among the 6 patients with EC combined with ovarian cancer,4 achieved complete remission after fertility-sparing treatment,among which 2 were of the POLE ultra-mutated molecular subtype and 1 was of the CNL subtype.The median time to complete remission was 8.5 months(ranging from 3 to 10 months),and 1 had a natural pregnancy and delivered at term.Among the 2 patients with EC combined with borderline ovarian tumors,1 achieved complete remission with a complete remission time of 11 months and delivered at term after assisted pregnancy through in vitro fertilization and embryo transfer(IVF-ET).③ Among the 8 patients,4 had endometrial cancer without superficial myometrial invasion,and 1 had complete remission;4 cases of endometrial cancer with superficial myometrial invasion,and 3 cases achieved complete remission.Among the 8 patients,2 cases of POLE super-mutated endometrial carcinoma and 5 cases of CNL;2 cases had complete remission were POLE and 3 were CNL remission.Conclusions The pathological types of endometrial cancer with ovarian malignant tumors are mainly low-grade,early and epithelial tumors,which have a good prognosis,and their fertility preservation treatment is feasible after careful evaluation and close follow-up.
endometrial cancersynchronous endometrial and ovarian cancerovarian cancerovarian borderline tumorfertility preservation
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