关键词: 子宫内膜样腺癌, 保守治疗, 宫腔镜, 电外科手术, 孕激素类, 芳香酶抑制剂, 减重手术

Abstract: Endometrial carcinoma is a common invasive malignant neoplasm, and conservative management of endometrioid endometrial carcinoma may be a therapeutic option for young nulliparae. Conventional drugs for conservative treatment include progestin, gonadotropin releasing hormone analogue, aromatase inhibitors. Hysteroscopy combined progestogen therapy is a novel therapeutic treatment for young women with early stage well-differentiated endometrioid endometrial cancer, and gains advantages in regression, pregnancy, relapse and adverse effect over treatment using drugs alone. There is no consensus, however, regarding the surgical procedures and ideal progestin agent, dose, or duration of treatment. Morbidly obese patients should accept obesity therapy to decrease the risk of recurrence, among which bariatric surgery has a better effect. Bariatric surgery is an effective intervention for young patients with early stage well-differentiated endometrioid endometrial cancer whose BMI is over 35 kg/m2. Bariatric surgery should be considered for patients who are inadequately controlled by non-surgical treatment with BMI≥35 kg/m2 or metabolic syndrome/T2DM (BMI≥30 kg/m2).

Key words: Endometrioid endometrial carcinoma, Fertility-preserving treatment, Hysteroscopes, Electrosurgery, Progestins, Aromatase inhibitors, Bariatric surgery