Organ preservation treatment of patients with atypical hyperplasia and endometrial cancer: current trends

The high prevalence and steady increase in the incidence of endometrial cancer dictate the need to prevent and improve the effectiveness of treatment of this disease. The solution of these issues is possible either by expanding the indications for surgical treatment in endometrial proliferative processes, or by improving conservative methods of therapy, which is of priority importance, since some patients often have the question of preserving reproductive function.Leading oncogynecological communities have come to a consensus: conservative treatment with preservation of fertility is possible and safe for young patients with endometrioid endometrial cancer of a high degree of differentiation, limited to endometrial damage only. According to published studies, the use of progestins gives a high frequency response to treatment in patients with atypical hyperplasia and early endometrial cancer. Combined treatment methods, including the use of metformin or hysteroscopic resection after drug therapy, can reduce the frequency of relapses.In the absence of larger prospective studies, it is very important to consider a woman's overall health and fertility potential before recommending conservative treatment for early endometrial cancer. It is necessary to conduct further randomized controlled trials in order to provide more convincing evidence of the benefits of a particular technique.