Hysteroscopic Resection in Fertility-Sparing Surgery for XXXX and Endometrial Cancer: Safety and Efficacy.

@entity1 @entity1204 @entity249 @entity5 @entity1373 @entity1871 @entity6303 @entity1869
STUDY OBJECTIVES: To evaluate the rate of intrauterine adhesions after hysteroscopic resection of @entity5 areas and the efficacy of combined treatment. DESIGN: Observational retrospective study. SETTING: @entity1 affected by @entity1869 or early stage @entity1204 . @entity1 : Twenty-three @entity1 , up to 45 years of age. INTERVENTION: Conservative treatment based on hysteroscopic resection of @entity5 areas and subsequent therapy with @entity6303 160 mg/day. METHODS AND MAIN RESULTS: Approximately 5% of @entity1204 ( @entity1204 ) are diagnosed in @entity1 younger than 40 years old, usually with a good prognosis. From 2010 to 2014, 23 @entity1 , up to age 45 years, who were affected by @entity1204 ( @entity1204 ) grade 1 or @entity1373 ( @entity1373 ) and who wished to preserve fertility, underwent conservative treatment based on hysteroscopic resection of the @entity5 areas and subsequent therapy with @entity6303 160 mg/day. Data with regard to age, body mass index, symptoms, history of @entity249 , and previous assisted reproductive technologies attempts, obstetrics history, previous diagnosis of intrauterine sinechiae, hysteroscopic findings, duration of therapy, follow-up reports, and reproductive outcomes were collected and analyzed. Of the 23 @entity1 enrolled in the study, 3 @entity1 (13%) presented with an endometrioid @entity1204 grade 1, and 20 @entity1 (87%) had @entity1373 . Twelve @entity1 (52.2%) had complete remission after 3 months of progestin therapy, 9 @entity1 (39.1%) had a complete remission after 6 months, and 2 (8.7%) @entity1 had remission after 9 months. Six @entity1 underwent a second hysteroscopic resection. The 3 @entity1 with an initial diagnosis of @entity1204 had complete remission after a mean of 4 months of high-dose progestin therapy; in @entity1 with @entity1373 , remission occurred after a mean of 3 months. In all @entity1 , intrauterine adhesions were not detected at any follow-up diagnostic hysteroscopy. After a median follow-up time of 25 months (range 8-37), we registered 1 (4.3%) relapse of disease. A total of 7 pregnancies in 6 @entity1 were counted, after an average time of 7.4 months (range 3-13 months) after the end of @entity1871 therapy. CONCLUSIONS: Hysteroscopic resection of @entity5 areas before high dosage progestin therapy seems to be a safe and effective approach in the management of @entity1373 and in @entity1 with early @entity1204 who wish to preserve fertility.
