文献詳細
今月の臨床 がん妊孕性温存治療の適応と注意点─腫瘍学と生殖医学の接点
婦人科腫瘍学 : 子宮体癌
文献概要
●手術回避のための手段ではない.温存治療の適格基準を遵守する.
●症例のリクルートや寛解の判定には必ず全面掻爬の標本を用いる.
●再発までの期間は限定されている.治療後は維持療法もしくはIVF-ETによる積極的不妊治療を行う.
●症例のリクルートや寛解の判定には必ず全面掻爬の標本を用いる.
●再発までの期間は限定されている.治療後は維持療法もしくはIVF-ETによる積極的不妊治療を行う.
参考文献
1) 婦人科腫瘍委員会報告.日産婦誌66 : 995─1038, 2014
2) Thigpen JT, et al : Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma : a dose-response study by the Gynecologic Oncology group. J Clin Oncol 17 : 1736─1744, 1999
3) 日本婦人科腫瘍学会 : 子宮体がん治療ガイドライン2013年版.pp144─159,金原出版,2013
4) Trimble CL, et al : Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia. A gynecologic oncology group study. Cancer 106 : 812─819, 2006
5) Nakao Y, et al : MR imaging in endometrial carcinoma as a diagnostic tool for the absence of myometrial invasion. Gynecol Oncol 102 : 343─347, 2006
6) Gallos ID, et al : Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia : a systematic review and metaanalysis. Am J Obstet Gynecol 207 : 266. e1─12, 2012
7) Ushijima K, et al : Multicenter phase II study of fertility-sparing treatment with medrxypogesterone acetate for endometrial carcinoma and atypical hyperplasia in young women. J Clin Oncol 25 : 2798─2803, 2007
8) 三橋 暁,生水真紀夫 : 子宮体がんでの妊孕性温存療法の新たな展開.産婦の実際62 : 1207─1213, 2013
9) Gallos ID, et al : Oral progestogens vs levonorgestrel-releasing intrauterine system for endometrial hyperplasia : a systematic review and metaanalysis. Am J Obstet Gynecol 203 : 547. e1─10, 2010
10) Baker J, et al : Efficacy of oral intrauterine device-delivered progestin in patients with complex endometrial hyperplasia with atypia or early endometrial adenocarcinoma : a meta-analysis and systemic review of the literature. Gynecol Oncol 125 : 263─270, 2012
11) Kim MK, et al : Combined medroxyprogesterone acetate levonorgestrel-intrauterine system treatment in young women with early-stage endometrial cancer. Am J Obstet Gynecol 209 : 358. e1─4, 2013
12) Wheller DT, et al : Histologic alterations in endometrial hyperplasia and well-differentiated carcinoma treated with progestins. Am J Surg Pathol 31 : 988─998, 2007
13) Koskas M, et al : Prognostic factors of oncologic and reproductive outcomes in fertility-sparing management of endometrial atypical hyperplasia and adenocarcinoma : systematic review and meta-analysis. Fertil Steril 101 : 785─794, 2014
14) Gonthier C, et al : Impact of obesity on the results of fertility-sparing management for atypical hyperplasia and grade 1 endometrial cancer. Gynecol Oncol 133 : 33─37, 2014
15) Fujimoto A, et al : The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer. J Assist Reprod Genet 31 : 1189─1194, 2014
16) Ichinose M, et al : The influence of infertility treatment on the prognosis of endometrial cancer and atypical complex endometrial hyperplasia. Int J Gynecol Cancer 23 : 288─293, 2013
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