Fertility-Sparing Treatment in Women with Atypical Hyperplasia/Endometrioid Intraepithelial Neoplasia/ Endometrial Cancer: A Tertiary Cancer Center Experience

Objective: The present study aims to evaluate the oncological and obstetric outcomes after fertility-sparing treatment in patients with endomet- rial atypical hyperplasia (AH), endometrioid intraepithelial neoplasia (EIN), and endometrioid adenocarcinoma (EC). Materials and Methods: We retrospectively analyzed the records of patients with AH/EIN and EC who underwent fertility-preserving treatment in a tertiary gynecologi- cal cancer center between February 2014 and July 2020. The median follow-up was 52 (range, 6-75) months. Results: The complete response rate was 75.9%. All of the patients with EC (n=2) had stable disease after the treatment of 6 months. Twenty-two (81.5%) patients of 27 pati- ents with AH/EIN had a complete response after the treatment of 6-12 months. Two of AH/EIN patients progressed to grade 1 endometrioid endometrial cancer, and 3 of AH/EIN patients had stable disease during the 6-month treatment period. The time to complete response was ≤ 6 months in 13 (59.1%) and >6 months in 9 (40.9%) patients in the AH/EIN group. One patient with AH/EIN after complete response became pregnant spontaneously and she gave a healthy birth. The recurrence rate was 9.1%. Conclusion: Fertility-sparing treatment modalities could be feasible in women with precursor lesions of endometrial carcinoma or low-grade endometrial cancer who want to preserve their fertility within close fol-low-up.