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In Endometrial Cancer, Uterus-Sparing Approach Effective

Levonorgestrel-release intrauterine device plus gonadotropin-releasing hormone studied

WEDNESDAY, Sept. 29 (HealthDay News) -- The combined use of a levonorgestrel-release intrauterine device (LNG-IUD) and gonadotropin-releasing hormone (GnRH) appears to be effective for treating women under 40 years of age with atypical endometrial hyperplasia (AEH) or well-differentiated (G1), endometrioid endometrial cancer (EC) limited to the endometrium, who want to preserve their fertility, according to a study published online Sept. 28 in the Annals of Oncology.

Between January 1996 and June 2009, Lucas Minig, M.D., of the Hospital Universitario Madrid Norte Sanchinarro in Spain, and colleagues evaluated the efficacy of an LNG-IUD inserted for one year plus GnRH for six months among 20 women with AEH and 14 with EC.

The investigators found the complete response rate in patients with AEH to be 95 percent, and 57.1 percent in women with EC-G1. Progression of disease was found in one patient (5 percent) with AEH and four patients (28 percent) with EC, with recurrences occurring in four of 20 patients with AEH and two of 14 with EC-G1. The average relapse time was 36 months, with all patients alive and without evidence of disease at the last follow-up (mean, 29 months). The investigators also found that 11 spontaneous pregnancies occurred among nine women.

"The combined treatment showed effectiveness in a substantial proportion of patients with AEH and EC. Close follow-up during and after treatment is crucial," the authors write.

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