子宮內膜癌保守性治療的檢視

The Conservative Treatment of Endometrial Cancer

有15％子宮內膜癌發生在停經前，這類患者多希望能保有生育功能。因此，對第一期、分化良好、沒有肌肉層或子宮頸侵犯、黃體素與雌激素接受器為陽性的子宮內膜癌，我們可以提供一個保守治療的機會，通常予荷爾蒙治療，但必須與病患溝通清楚，說明可能的危險性，畢竟保守性治療並非治療子宮內膜癌的標準模式，以免因之延誤治癒的時機，引起不必要的醫療糾紛。荷爾蒙給予3個月後，應再做子宮內膜搔除和其它檢查，確定是否痊癒。一旦生育完成，盡快將子宮切除。

The majority of cases with endometrial cancer are postmenopausal with approximately 15% of patients accurring in women in premenopausal status. Prior trials largely support the conservative management of early endometrial cancer in women desiring future fertility. Appropriate candidates for conservative treatment are young patients with grade 1 endometrioid endometrial adenocarcinoma, no evidence of myometrial invasion, no evidence of lymph node metastasis, and strong expression of progesterone receptors as well as estrogen receptors. It is important to ensure that patients desiring to proceed with hormonal management are extensively counseled regarding potential risks. Treating with less than the standard of care could potentially result in a young woman dying of a surgically curable disease. Typical surveillance includes endometrial sampling every 3 months. Once childbearing is completed, it is recommended that these women proceed with definitive treatment with hysterectomy.