A review of the challenges faced in the conservative treatment of young women with endometrial carcinoma and risk of ovarian cancer Journal Article
| Authors: | Zivanovic, O.; Carter, J.; Kauff, N. D.; Barakat, R. R. |
| Article Title: | A review of the challenges faced in the conservative treatment of young women with endometrial carcinoma and risk of ovarian cancer |
| Abstract: | Objective: The standard management for women diagnosed with endometrial carcinoma (EC) is hysterectomy with salpingo-oophorectomy. However, more conservative treatment approaches, including uterine and ovarian preservation, may be used for women who have a strong desire to maintain fertility in spite of potential oncologic risks. Methods: We reviewed the literature regarding fertility-preserving treatment for EC. We also conducted medical chart reviews for two young patients diagnosed with EC whose treatment deviated from the standard approach in order to preserve fertility. These patients were subsequently diagnosed with ovarian cancer. Our review summarizes the literature regarding the clinical and emotional implications of fertility preservation in young women. Cases: Two young nulliparous women (29 and 23 years, respectively) with grade 1 endometrioid adenocarcinoma were initially treated with conservative fertility-sparing endocrine therapy. Upon failure of endocrine treatment both women underwent hysterectomy and staging with ovarian preservation. During surveillance, both women were subsequently diagnosed with ovarian carcinoma and underwent bilateral salpingo-oophorectomy (BSO) and comprehensive staging. Conclusion: The management of young women with endometrial cancer can be complex and challenging. Patients and physicians are confronted with the dilemma of following standard surgical guidelines versus the desire to maintain fertility and avoid surgical menopause. Careful oncologic, psychotherapeutic, genetic and reproductive counseling is advised before offering a non-standard treatment strategy to young endometrial cancer patients. © 2009 Elsevier Inc. All rights reserved. |
| Keywords: | adult; histopathology; review; cancer recurrence; case report; cancer risk; cancer staging; endometrium carcinoma; hysterectomy; lymph node dissection; laparotomy; salpingooophorectomy; ovarian cancer; ovary cancer; medical record review; cancer hormone therapy; vaginal hysterectomy; drug treatment failure; endometrial carcinoma; psychotherapy; female fertility; endometrium biopsy; megestrol acetate; embryo transfer; oocyte retrieval; ovulation induction; fertility preservation; young women; gestagen; ovarian preservation |
| Journal Title: | Gynecologic Oncology |
| Volume: | 115 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2009-12-01 |
| Start Page: | 504 |
| End Page: | 509 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2009.08.011 |
| PROVIDER: | scopus |
| PUBMED: | 19758691 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: GYNOA" - "Source: Scopus" |
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