早期子宮內膜癌保守性治療的新知

Fertility- Sparing Treatment for Early Endometrial Cancer

子宮內膜癌的標準治療方式是分期手術。但患者如尚未完成生育，如何兼顧治療與生育，便顯得很重要。常用的保留生育的治療方法主要為口服黃體素，如予以medroxyprogesteroneacetate（MPA）或megestrol acetate（MA），其它治療方法尚有GnRHa、釋放levonorgestrel的子宮內避孕器、芳香酶抑制劑、metformin、子宮鏡內膜切除，或合併上述方法。同時建議，患者在完成治療後，在3個月內便能懷孕，一旦完成生育，宜立即切除子宮，避免復發。

The standard treatment for endometrial cancer is staging operation. However,most young women with endometrial cancer have a strong desire to bear children.It is imperative to provide them with fertility-sparing options that will allowthem the opportunity to get pregnant while at the same time provide them withadequate treatment of their cancer. The most common type of fertility-sparingmanagement involves progestin via use of oral medroxyprogesterone acetate(MPA) or megestrol acetate (MA). Other therapies that have been evaluatedinclude GnRH agonist, intrauterine devices (IUDs) releasing levonorgestrel,aromatase inhibitor, metformin, hysteroscopic tumor resection, or a combinationof these therapies. It is recommended that patients attempt to conceiveapproximately 3 months after the completion of therapy. Hysterectomy is advisableafter completion of childbirth, given the high recurrence rates after conservativetreatment.