ArticleVirchows Archiv : an international journal of pathology2025
Endometrial assessment for fertility-sparing treatment of young women with early-stage endometrial carcinoma: adaptation of a standardized synoptic reporting.
Article in Virchows Archiv : an international journal of pathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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