Clinicopathologic characteristics and treatment features of women with the incidental diagnosis of endometrial adenocarcinoma during infertility follow-up in Ankara, Turkey

Abstract

Objective: The aim of this study was to investigate the clinical and laboratory features of patients with the incidental diagnosis of endometrial adenocarcinoma (EC) during infertility work-up, with special attention given to treatment approaches, recurrence rate, and fertility outcome. Material and Methods: The medical records of 577 patients who were diagnosed with EC and treated between 2007 and 2013 were included in the study. Out of 577 EC patients, 5.1% (n = 30) were ≤ 40 years of age. However, 10 patients had a history of infertility and had been diagnosed during evaluation for infertility. Patients' clinical and laboratory data were reviewed retrospectively. Results: The mean age at diagnosis was 34.3 ± 4.5 years and the mean duration of infertility was 5.1 ± 4.7 years. Immediate staging surgery was performed on three patients. The others were treated with oral megestrol acetate and/or a levonorgestrel-containing intrauterine device (IUD) for 6 months. The mean duration of postoperative or postdiagnostic follow-up was 44.7 ± 25.9 months. The disease persistence and recurrence rates were 11.1% and 22.2%, respectively. Two patients achieved pregnancy naturally or by assisted reproductive technology (ART) trial. Conclusion: The investigation of patients during infertility work-up provides an opportunity to evaluate the endometrium and its malignancies in young women, when the disease is in its early stage and symptom free. The standard surgical treatment for early-stage EC is total hysterectomy with bilateral salpingo-oophorectomy. However, conservative management of early stage EC with progestational drugs, especially in young patients who wish to preserve their fertility, is acceptable with the possibility of future pregnancies.

Keywords

• endometrial adenocarcinoma
• fertility conservation
• infertility
• obesity
• young women