Endometrial Cancers in Young Women: Conservative Management and Fertility Preserving Options
Endometrial cancer is increasingly being diagnosed in women <40 years. Around 1.6 % cases occur between 20 and 34 year age and 6 % between 35 and 44 years of age according to the SEER statistics . A woman under the age of 40 has a 1 in 1423 risk of developing endometrial cancer . Genetic predisposition and conditions with estrogen excess are the main risk factors. Women <40 years, with well differentiated stage 1a cancer can be offered conservative management after appropriate counseling and investigative work-up. Progestins form the mainstay of treatment in addition to other novel strategies. Pregnancy rates of 30-40% have been reported after conservative management.
KeywordsEndometrial Cancer Lynch Syndrome Megestrol Acetate Myometrial Invasion Medroxyprogesterone Acetate
- 1.Howlader N et al. SEER cancer statistics review, 1975–2008. 2011 [cited 2011; based on Nov 2010 SEER data submission]. Available from: http://seer.cancer.gov/csr/1975_2008/
- 4.Smith RA, von Eschenbach AC, Wender R et al; ACS Prostate Cancer Advisory Committee, ACS Colorectal Cancer Advisory Committee, ACS Endometrial Cancer Advisory Committee. American Cancer Society Guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. CA Cancer J Clin. 2001;51(1):38–75.Google Scholar
- 12.Dreisler E, Poulsen LG, Antonsen SL et al; European Menopause and Andropause Society. EMAS clinical guide: assessment of the endometrium in peri and postmenopausal women. Maturitas 2013;75(2):181–90.Google Scholar
- 31.Gallos ID, Yap J, Rajkhowa M, Luesley DM, Coomarasamy A, Gupta JK. Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis. Am J Obstet Gynecol. 2012;207(4):266.e1–12.CrossRefGoogle Scholar