Young patients with the endometrial cancer IA who desire to preserve fertility, can\nselect the conservative therapy with progestin. However, the therapy involves risks of\nprogression and relapse. We examined immunohistochemical analyses of phosphatase\nand tension homolog (PTEN) and p53 expressions to predict the early relapse,\nand pregnancy and delivery. Twenty women with endometrial cancer, FIGO IA\n(1988) (FIGO staging was essentially defined post-surgically), instead of the pathogical\nspecimen before surgery without myometrial invasion were estimated by MRI\nunder 40 years at Gifu University Hospital, Japan from 1988 to 2009. Patients were\ntreated with medroxyprogesterone acetate (MPA, 400 - 600 mg/day) for 4 - 10\nmonths, with whole wall endometrial curettage performed every four weeks. Response\nto the therapy, pregnancy, delivery and relapse of disease during follow-up\nover a 72-month period. Immunohistochemical expression of PTEN and p53 was also\nevaluated with pregnancy, delivery and relapse rate. All patients had pathological\ncomplete remissions within 4 - 10 months. Relapse rate was high (60%) in more than\n72 months. Immunohistochemical PTEN retain in tumor cells before MPA treatment\n(8/10) was significant better correlation with pregnancy and delivery rate than of lost\ncases (1/5) in non-obese women (P < 0.05). Conservative therapy is feasible in carefully\nselected young women with endometrial cancer without myometrial invasion.\nHowever, the relapse rate was high. In cases who desire to be a pregnant, an earlier\ninfertility treatment may be considered especially for PTEN loss especially in nonobese\ncases.
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