METHODS: All patients received GnRH agonist for 3 months after an endometrial resection combined with a laparoscopy to exclude concomitant ovarian tumor and/or other extra-uterine disease. The patient underwent a follow-up of 3 months interval with endometrial sampling by hysteroscopy. Main Outcome Measure(s): The recurrence rate and the pregnancy rate after fertility sparing treatment. Results: We identified 9 patients with EIN (50%), 7 patients with G1EC (38.9%), 1 with combined histology (5.5%), and 1 with G2EC (5.5%). After a median follow-up of 40.7 months, 12 patients conserved their uterus (66.7%), and 8 (53.3%) patients were pregnant with a total of 14 pregnancies among those who tried to become pregnant. We observed a complete response rate in 12 patients (66.7%) but 3 of these patients relapsed (25%). We also found a stable disease in 6 patients (33.3%). Conclusions: Compared with other fertility sparing treatments, GnRH agonist after surgery is an effective fertility-sparing strategy for women with EIN and/or G1EC. We recommend hysterectomy once a family has been completed even if the literature does not clearly lead to radical surgery.
方法:所有患者在子宫内膜切除术联合腹腔镜检查后接受GnRH激动剂3个月,以排除伴随的卵巢肿瘤和/或其他子宫外疾病。患者接受了为期3个月的随访,并通过宫腔镜进行子宫内膜采样。主要结果指标:保留生育能力治疗后的复发率和妊娠率。结果:我们确定了9例EIN患者(50%),G1EC患者7例(38.9%),合并组织学1例(5.5%),1与G2EC(5.5%)。经过40.7个月的中位随访,12例患者保留子宫(66.7%),8例(53.3%)患者怀孕,试图怀孕的患者中共有14例怀孕。我们观察到12名患者(66.7%)的完全缓解率,但其中3名患者复发(25%)。我们还发现6例患者(33.3%)病情稳定。结论:与其他保留生育的治疗方法相比,手术后GnRH激动剂是EIN和/或G1EC女性的有效生育策略。即使文献没有明确导致根治性手术,我们也建议在家庭完成后进行子宫切除术。