Table 2.
Studies of progestins in the setting of fertility‐sparing treatment of early‐staged LGESS
| Study (y) | n | Stage | ER/PR | Hormonal treatment | Treatment duration | Pregnancy desire | Pregnancy | Successful parturition | Management after pregnancy and outcome |
|---|---|---|---|---|---|---|---|---|---|
| Stadsvold (2005)59 | 1 | IB | 1 +/+ | MA 100 mg/d | – | 0 | 0 | 0 | No TH±BSO, NED 21 mo |
| Sanchez (2012)60 | 1 | IB | 1 +/+ | MA 160 mg/d | – | 2 | 2 (1 by ART) | 2 | Recurrence after 2 y, TH+GnRHa+MA 160 mg/d, NED 5 y |
| Delaney (2012)61 | 1 | IB | 1 +/+ | MA | 8 y | 1 | 1 | 1 | No TH±BSO, NED 8 y |
| Zhan (2014)62 | 1 | IB | – | CT+MPA 250 mg/d | 7 mo | 1 | 1 | 1 | No TH±BSO, NED 47 mo |
| Morimoto (2015)63 | 1 | – | 1 +/+ | MPA 600 mg/d | 39 mo | 0 | 0 | 0 | Recurrence after 39 mo, TH+BSO+RT+CT+GnRHa, DOD |
| Dong (2014)64 | 1 | – | 1 +/+ | MPA 250 mg/d | 1 y | 1 | 1 | 1 | No TH±BSO, NED about 3 y |
| Laurelli (2015)30 | 5 | 5 IA | 5 +/+ | MA 160 mg/d | 1‐2 y | – | 2 | 1 | 1 No TH±BSO, 4 TH+BSO, NED 30‐54 mo |
| Jin (2015)65 | 4 | – | 4 +/+ | MA 160‐320 mg/d | 5‐6 mo | 3 | 3 (1 by ART ) | 3 |
3 No TH±BSO, NED 13‐36 mo 1 Recurrence after 10 mo, TH+MA 320 mg/d, NED 10 mo |
| Xie (2016)26 | 10 |
3 IA 7 IB |
– |
8 MA/MPA 2 CRS+MA+CTa |
– | 5 | 5 (1 by ART ) | 5 |
5 No TH±BSO, NED 4‐106 mo 1 Recurrence after 4 mo, FSS+MA, NED 39 mo 2 Recurrence after 3‐18 mo, TH+BSO+GnRHa, NED 13‐32 mo 1 Recurrence after 26 mo CRS+MA+CT, NED 77 mo 1 Recurrence after 24 mo, local tumorectomy, NED 48 mo |
| Total | 25 | MA/MPA | 15 | 14 | NED 4‐106 mo |
ART, assisted reproduction technology; BSO, bilateral salpingo‐oophorectomy; CRS, cytoreductive surgery; CT, Chemotherapy; DOD, death of disease; FSS, fertility‐sparing surgery; MA, megestrol acetate; MPA, medroxyprogesterone acetate; NED, No evidence of disease; RT, Radiotherapy; TH, total hysterectomy; —, the data were not described clearly.
a
After the primary fertility‐sparing treatment, recurrence was found during pregnancy in two patients who underwent cesarean delivery and cytoreductive surgery followed by adjuvant MA and chemotherapy.