Endometrial assessment for fertility-sparing treatment of young women with early-stage endometrial carcinoma: adaptation of a standardized synoptic reporting.
Zitong Zhao, Joella Xiaohong Ang, Ravichandran Nadarajah, Shing Lih Wong
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引用次数: 0
Abstract
Recent guidelines emphasize regular endometrial assessment for fertility-sparing treatment (FST) in endometrial carcinoma (EC), but no consensus exists on histological reporting. We reviewed 14 patients under 40 years old with early-stage, low-grade endometrial endometrioid carcinoma (EEC) treated with FST. Our patients received oral therapy (28.6%) or combined oral therapy with intrauterine device (71.4%), and were followed for 11-76 months (median, 31.5 months). Using a classification proposed by Wheeler et al., treatment outcomes included resolution (50%), persistence (14.3%), progression (14.3%), and recurrence (21.4%). Resolution occurred within 4-15 months. Two patients achieved successful pregnancies. Three underwent hysterectomy, including one with progression and distant metastasis. We find that young women with EEC often extend FST beyond recommended durations due to strong fertility desires, increasing progression risk. Standardized synoptic reporting with routine reviews of prior biopsies, obtaining deeper tissue sections, and seeking second opinions can improve endometrial assessment and guide treatment.
期刊介绍:
Manuscripts of original studies reinforcing the evidence base of modern diagnostic pathology, using immunocytochemical, molecular and ultrastructural techniques, will be welcomed. In addition, papers on critical evaluation of diagnostic criteria but also broadsheets and guidelines with a solid evidence base will be considered. Consideration will also be given to reports of work in other fields relevant to the understanding of human pathology as well as manuscripts on the application of new methods and techniques in pathology. Submission of purely experimental articles is discouraged but manuscripts on experimental work applicable to diagnostic pathology are welcomed. Biomarker studies are welcomed but need to abide by strict rules (e.g. REMARK) of adequate sample size and relevant marker choice. Single marker studies on limited patient series without validated application will as a rule not be considered. Case reports will only be considered when they provide substantial new information with an impact on understanding disease or diagnostic practice.