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Bariatric Surgery for Fertility-Sparing Treatment of Atypical Hyperplasia and Grade 1 Cancer of the Endometrium

Endometrial Cancer | Bariatric Surgery Candidate | Atypical Hyperplasia

A growing population of young women with obesity are developing atypical hyperplasia (pre-cancer) and endometrial cancer. Progestin is the standard treatment for women who wish to preserve fertility, but this approach does not address the underlying cause of endometrial cancer/atypical hyperplasia (obesity); thus response rates are low and recurrence rates are high. Significant weight loss by bariatric surgery, in combination with progestin therapy may result in greater and more durable response rates.

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Conditions de participation

  • Sexe:

    FEMALE

  • Âges admissibles:

    18 to 41

Critères de participation

Inclusion Criteria:

* BMI ≥ 35
* Diagnosis of grade 1 endometrioid endometrial cancer or complex atypical hyperplasia
* Clinical stage 1 disease - no evidence of metastatic disease beyond the uterus by physical exam or imaging performed (MRI, CT)
* ECOG status \<2
* Desire for fertility preservation
* No contraindications to progestin intrauterine device (IUD)
* Have signed an approved informed consent form

Exclusion Criteria:

* Evidence of myometrial invasion or extra-uterine disease on imaging
* High grade or p53 endometrial cancer
* History of other malignancies, except if curatively treated with no evidence of disease for \> 5 years
* Evidence of adenomyosis seen on MRI
* Previous major upper abdominal surgery (ex. splenectomy, partial gastrectomy, liver resection, bowel resection). \*Appendectomy, cholecystectomy, hernia repair, and caesarean section are acceptable procedures for inclusion
* Current use of weight loss medication
* Contraindications to sleeve gastrectomy
* Medical co-morbidity with end-organ dysfunction
* Unable to understand and participate in the informed consent process
* Currently pregnant

Lieu de l'étude

Princess Margaret Hospital
Princess Margaret Hospital
Toronto, Ontario
Canada

Contactez l'équipe d'étude

Étude parrainée par
University Health Network, Toronto
Participants recherchés
Plus d'informations
ID de l'étude: NCT04008563