Measurement of endometrial thickness by transvaginal ultrasonography to predict pathological response to medroxyprogesterone acetate in patients with grade 1 endometrioid adenocarcinoma

Sato,Masakazu; Arimoto,Takahide; Kawana,Kei; Miyamoto,Yuichiro; Ikeda,Yuji; Tomio,Kensuke; Tanikawa,Michihiro; Sone,Kenbun; Mori‑Uchino,Mayuyo; Tsuruga,Tetsushi; Nagasaka,Kazunori; Adachi,Katsuyuki; Matsumoto,Yoko; Oda,Katsutoshi; Osuga,Yutaka; Fujii,Tomoyuki

doi:10.3892/mco.2016.748

Measurement of endometrial thickness by transvaginal ultrasonography to predict pathological response to medroxyprogesterone acetate in patients with grade 1 endometrioid adenocarcinoma

Authors:
- Masakazu Sato
- Takahide Arimoto
- Kei Kawana
- Yuichiro Miyamoto
- Yuji Ikeda
- Kensuke Tomio
- Michihiro Tanikawa
- Kenbun Sone
- Mayuyo Mori‑Uchino
- Tetsushi Tsuruga
- Kazunori Nagasaka
- Katsuyuki Adachi
- Yoko Matsumoto
- Katsutoshi Oda
- Yutaka Osuga
- Tomoyuki Fujii
View Affiliations

Affiliations: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo 1138655, Japan
Published online on: January 28, 2016 https://doi.org/10.3892/mco.2016.748
Pages: 492-496
Copyright: © Sato et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to evaluate whether measuring endometrial thickness during fertility‑sparing treatment with medroxyprogesterone acetate (MPA) can be a predictive marker for effectiveness in women with endometrioid adenocarcinoma, grade 1 (EmCa, G1). A total of 32 patients with stage IA EmCa, G1 underwent treatment with MPA. Patients were <40 years of age and preferred fertility‑sparing treatment. MPA (600 mg/day) with low‑dose aspirin was administered orally for 26 weeks. Pathological evaluation was performed by total curettage at weeks 8 and 16 and by fractional curettage at week 26. Patients underwent curative surgery in case of disease progression. Endometrial thickness was measured by transvaginal ultrasonography at weeks 8 and 16. Patients who showed non‑complete response (non‑CR) had thicker endometrium than that of CR patients at weeks 8 and 16. Receiver operating characteristic analysis revealed cut‑off values of 8.3 and 4.7 mm endometrial thickness at weeks 8 and 16, respectively, for non‑CR. Endometrial thickness >5 mm at week 16 was an independent factor for prediction of non‑CR. Measurement of endometrial thickness during MPA treatment may be useful as a predictive marker for pathological response to MPA in patients with EmCa, G1.

View Figures

View References

1	Pecorelli S: Revised FIGO staging for carcinoma of the vulva, cervix and endometrium. Int J Gynaecol Obstet. 105:103–104. 2009. View Article : Google Scholar : PubMed/NCBI
2	Park H, Seok JM, Yoon BS, Seong SJ, Kim JY, Shim JY and Park CT: Effectiveness of high-dose progestin and long-term outcomes in young women with early-stage, well-differentiated endometrioid adenocarcinoma of uterine endometrium. Arch Gynecol Obstet. 285:473–478. 2012. View Article : Google Scholar : PubMed/NCBI
3	Kalogiannidis I and Agorastos T: Conservative management of young patients with endometrial highly-differentiated adenocarcinoma. J Obstet Gynaecol. 31:13–17. 2011. View Article : Google Scholar : PubMed/NCBI
4	Laurelli G, Di Vagno G, Scaffa C, Losito S, Del Giudice M and Greggi S: Conservative treatment of early endometrial cancer: Preliminary results of a pilot study. Gynecol Oncol. 120:43–46. 2011. View Article : Google Scholar : PubMed/NCBI
5	Bovicelli A, D'Andrilli G, Giordano A and De Iaco P: Conservative treatment of early endometrial cancer. J Cell Physiol. 228:1154–1158. 2013. View Article : Google Scholar : PubMed/NCBI
6	Morelli M, Di Cello A, Venturella R, Mocciaro R, D'Alessandro P and Zullo F: Efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the prevention of the atypical endometrial hyperplasia and endometrial cancer: Retrospective data from selected obese menopausal symptomatic women. Gynecol Endocrinol. 29:156–159. 2013. View Article : Google Scholar : PubMed/NCBI
7	Cade TJ, Quinn MA, Rome RM and Neesham D: Progestogen treatment options for early endometrial cancer. BJOG. 117:879–884. 2010. View Article : Google Scholar : PubMed/NCBI
8	Ramirez PT, Frumovitz M, Bodurka DC, Sun CC and Levenback C: Hormonal therapy for the management of grade 1 endometrial adenocarcinoma: A literature review. Gynecol Oncol. 95:133–138. 2004. View Article : Google Scholar : PubMed/NCBI
9	Gunderson CC, Fader AN, Carson KA and Bristow RE: Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma: A systematic review. Gynecol Oncol. 125:477–482. 2012. View Article : Google Scholar : PubMed/NCBI
10	Chang WH, Chen CH and Yu MH: Conservative therapy of stage I endometrial adenocarcinoma and atypical endometrial hyperplasia for the preservation of fertility. Int J Gynaecol Obstet. 92:137–138. 2006. View Article : Google Scholar : PubMed/NCBI
11	Fujiwara H, Jobo T, Takei Y, Saga Y, Imai M, Arai T, Taneichi A, Machida S, Takahashi Y and Suzuki M: Fertility-sparing treatment using medroxyprogesterone acetate for endometrial carcinoma. Oncol Lett. 3:1002–1006. 2012.PubMed/NCBI
12	Yahata T, Fujita K, Aoki Y and Tanaka K: Long-term conservative therapy for endometrial adenocarcinoma in young women. Hum Reprod. 21:1070–1075. 2006. View Article : Google Scholar : PubMed/NCBI
13	Ushijima K, Yahata H, Yoshikawa H, Konishi I, Yasugi T, Saito T, Nakanishi T, Sasaki H, Saji F, Iwasaka T, et al: Multicenter phase II study of fertility-sparing treatment with medroxyprogesterone acetate for endometrial carcinoma and atypical hyperplasia in young women. J Clin Oncol. 25:2798–2803. 2007. View Article : Google Scholar : PubMed/NCBI
14	Fujimoto A, Ichinose M, Harada M, Hirata T, Osuga Y and Fujii T: The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer. J Assit Repord Genet. 31:1189–1194. 2014. View Article : Google Scholar
15	Shufaro Y, Simon A, Laufer N and Fatum M: Thin unresponsive endometrium-a possible complication of surgical curettage compromising ART outcome. J Assit Repord Genet. 25:421–425. 2008. View Article : Google Scholar
16	Yamazawa K, Hirai M, Fujito A, Nishi H, Terauchi F, Ishikura H, Shozu M and Isaka K: Fertility-preserving treatment with progestin and pathological criteria to predict responses, in young women with endometrial cancer. Hum Reprod. 22:1953–1958. 2007. View Article : Google Scholar : PubMed/NCBI
17	Minaguchi T, Nakagawa S, Takazawa Y, Nei T, Horie K, Fujiwara T, Osuga Y, Yasugi T, Kugu K, Yano T, et al: Combined phospho-Akt and PTEN expressions associated with post-treatment hysterectomy after conservative progestin therapy in complex atypical hyperplasia and stage Ia, G1 adenocarcinoma of the endometrium. Cancer Lett. 248:112–122. 2007. View Article : Google Scholar : PubMed/NCBI
18	Minagawa Y, Sato S, Ito M, Onohara Y, Nakamoto S and Kigawa J: Transvaginal ultrasonography and endometrial cytology as a diagnostic schema for endometrial cancer. Gynecol Obstet Invest. 59:149–154. 2005. View Article : Google Scholar : PubMed/NCBI