Аннтотация

© Bionika Media Ltd. Objective. To investigate whether early endometrial cancer can be treated and whether fertility can be preserved in young women, by using a hormonal combination: levonorgestrel intrauterine hormonal system (LNG-IUS; Mirena 52 mg of LH) and gonadotropin-releasing hormone agonists (Zoladex 3.6 mg). Subjects and methods. The investigation covered 79 patients. The case histories of 37 patients with atypical hyperplasia and 42 with stage IA (T1aNxMo) endometrial cancer were analyzed. The patients’ mean age was 33 years. The investigation was conducted at the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation. Results. Primary treatment was completed in 67 (84.8%) patients and in 12 (15.2%) during hormonal treatment. After completion of special treatment, 8 (11.9%) of the 67 women had 10 pregnancies that resulted in childbirth and spontaneous miscarriage in 8 and 2 cases, respectively. Recurrences and incurable disease were stated in 3 (4.2%) and 9 (12.8%) cases, respectively. Repeated hormone therapy cycles were not performed because the patients had refused organ-sparing treatment. All the 12 (17.1%) patients were successfully operated on. Conclusion. The proposed treatment regimen is a highly effective medical treatment in patients with precancer and early endometrial cancer. Independent hormone therapy is undoubtedly the best alternative to hysterectomy today in this group of patients who want to preserve reproductive function.