タバタ ツトム   Tabata Tsutomu
  田畑 務
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
招待の有無 招待あり
表題 Safety and efficacy of levonorgestrel-releasing intrauterine device in the treatment of atypical endometrial hyperplasia and early endometrial cancer.
掲載誌名 正式名:The journal of obstetrics and gynaecology research
略  称:J Obstet Gynaecol Res
ISSNコード:14470756/13418076
掲載区分国内
巻・号・頁 pp.1-7
著者・共著者 Hirata Toru, Kondo Eiji, Magawa Shoichi, Kubo-Kaneda Michiko, Nii Masafumi, Yoshida Kenta, Maezawa Tadashi, Tabata Tsutomu, Ikeda Tomoaki
担当区分 責任著者
発行年月 2022/08
概要 AIM:To investigate the recurrence rate, live-birth rate, and treatment outcomes of levonorgestrel-releasing intrauterine device (LNG-IUD) for the management of atypical endometrial hyperplasia (AEH) or Grade-1 endometrial cancer (EC) in patients who desire fertility-sparing treatment and those seeking conservative treatment without fertility preservation.METHODS:We prospectively enrolled nine patients from a single institution between April 2009 and September 2013 who were followed up for 60 months after LNG-IUD insertion.RESULTS:The median patient age was 35 (range: 29-39) years. The overall recurrence rate was 56% (5/9). The median interval between removal of the LNG-IUD and recurrence was 20.5 (range: 2-30) months. Three of the nine patients had Grade-1 EC, and six had AEH. The response rates to the LNG-IUD in patients with Grade-1 EC and AEH were 66% and 100%, respectively. Four patients (three with AEH, one with Grade-1 EC) experienced recurrence 6 months after MPA treatment and all 4 (100%) had complete response. Eight patients desired fertility preservation, of which 37% (3/8) conceived after receiving fertility treatment and 25% (2/8) had a live birth; the remaining three had previously received MPA for 6 months and had a recurrence; of these, 1 had a live birth.CONCLUSION:LNG-IUD is effective for the management of AEH and EC in young patients who desire fertility-sparing treatment, including those ineligible for MPA owing to the presence of comorbidities and those with recurrence after MPA treatment (6-month treatment), and patients seeking conservative treatment without fertility preservation.
DOI 10.1111/jog.15408
PMID 36054237