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| Effect of hysteroscopic resection and gonadotropin-releasing hormone agonists injection combined with levonorgestrel-intrauterine device system for treating patients with early endometrial cancer |
| Sanya Central Hospital (Hainan Third People’s Hospital), Sanya Hainan Province, 572000 |
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Abstract To analyze the effect of hysteroscopic resection and gonadotropin-releasing hormone agonists (GnRHa) injection combined with levonorgestrel- intrauterine system (LNG-IUS) for treating patients with early endometrial cancer (EC). Methods: A total of 105 patients with early EC from June 2014 to June 2019 were analyzed retrospectively. These patients were divided into control group (n=48) and observation group (n=57) according to different treatment methods. All patients had undergone hysteroscopic resection of the EC lesion, then the patients in the control group were treated with oral megestrol acetate combined with GnRHa injection, and the patients in the observation group were treated with LNG-IUS combined with GnRHa injection. The curative effect, the levels of tumor markers and inflammatory factors, the pregnancy outcomes, and the complications rate of the patients were observed and compared between the two groups. Results: The cumulative complete remission rate of these 105 patients in 3, 6, 9, and 12 months after operation were 60.0%, 73.3%, 81.0%, and 84.8%, respectively. There was no significant difference in the complete remission rate (87.7% vs. 81.3%) of the patients in 12 months after operation between the two groups (P＞0.05). The complication rate (15.8%) of the patients in the observation group was significantly lower than that (33.3%) of the patients in the control group (P<0.05). 105 patients were followed up for 29.8±9.3 months, and during this period, there were 50 patients with complete remission in the observation group with the pregnancy rate of 34.0% (17/50), and there were 39 patients with complete remission in the control group with the pregnancy rate of 28.2% (11 patients). The pregnancy rate of the patients had no significant difference between the two groups (P＞0.05). Univariate COX regression analysis showed that the value of body mass index <28 kg/m2 of the patients could shorten the time to complete remission after treatment (P=0.003). After 6 months of treatment, the levels of estrogen receptor, the inflammatory factors, and the tumor markers of the patients in the observation group were significantly lower than those of the patients in the control group (all P<0.05). Conclusion: Hysteroscopic resection and GnRHa injection combined with LNG-IUS for treating the patients with early EC has better prognosis, lower adverse reactions, and which has certain clinical application prospects, but it is necessary to strictly grasp the treatment indications of the patients and the patients should be followed up regularly.
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