Volume 44, Issue 1 p. 151-156
Original Article

Efficacy of medroxyprogesterone acetate treatment and retreatment for atypical endometrial hyperplasia and endometrial cancer

Satoshi Tamauchi

Satoshi Tamauchi

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

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Hiroaki Kajiyama

Corresponding Author

Hiroaki Kajiyama

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

Correspondence: Professor Hiroaki Kajiyama, Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 466-8550, Japan. Email: [email protected]Search for more papers by this author
Fumi Utsumi

Fumi Utsumi

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

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Shiro Suzuki

Shiro Suzuki

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

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Kaoru Niimi

Kaoru Niimi

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

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Jun Sakata

Jun Sakata

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

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Mika Mizuno

Mika Mizuno

Department of Gynecologic Oncology, Aichi Cancer Center,, Nagoya, Japan

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Kiyosumi Shibata

Kiyosumi Shibata

Department of Obstetrics and Gynecology, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan

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Fumitaka Kikkawa

Fumitaka Kikkawa

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan

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First published: 09 November 2017
Citations: 37

Abstract

Aim

Medroxyprogesterone acetate (MPA) is used to preserve fertility in patients with Grade 1 endometrial cancer without myometrial invasion (G1EA) and those with atypical endometrial hyperplasia (AEH). However, the efficacy of retreatment with MPA has not been sufficiently established for patients who experience recurrence but wish to retain their fertility. This study aimed to show the effectiveness of MPA treatment and retreatment for AEH and G1EA.

Methods

A total of 39 patients received MPA treatment between 2005 and 2015, including nine with G1EA and 30 with AEH. The patients received high-dose (600 mg/day) MPA for 26 weeks. If a complete response was not achieved, MPA treatment was continued. After complete remission, if there was a recurrence, the patient was offered a choice of a hysterectomy or retreatment with MPA. The gynecologic and obstetric outcomes were retrospectively analyzed.

Results

The median age was 34 years, and the median body mass index was 23.3 kg/m2. The median follow-up period was 52 months. Complete response rates for the initial treatment were 89% for G1EA and 93% for AEH. Recurrence occurred in 88% of patients with G1EA (7/8) and 50% of those with AEH (14/28). Seven patients with G1EA and 11 with AEH received MPA retreatment, and 100% and 92% of these achieved a complete response. During the study period, a total of 14 pregnancies were recorded with 10 live births.

Conclusion

MPA can be effective for G1EA and AEH treatment even when they recur.