臨床婦人科産科70巻4号

2016年04月発行

増刊号 ─知りたい最新情報がすぐわかる！─不妊・不育症診療パーフェクトガイド 1．悪性腫瘍の妊孕性温存治療

子宮体がんに対する黄体ホルモン療法の適応と注意点

著者： 牛嶋公生¹

所属機関： ¹久留米大学医学部産科婦人科学教室

ページ範囲：P.20 - P.22

Point
◉温存療法の適応は，筋層浸潤のない高分化型類内膜腺癌である．
◉治療前，治療中，終了時の組織学的評価は必ず全面掻爬材料で行う．
◉再発率が高く，消失後は早期にIVF-ETの導入を計画する．

参考文献

1）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

2）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

3）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

4）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

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）Wheller DT, et al : Histologic alterations in endometrial hyperplasia and well-differentiated carcinoma treated with progestins. Am J Surg Pathol 31 : 988─998, 2007

7）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

8）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

9）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