DM = Diabetes Mellitus.
The patients included in the study were diagnosed between 2020 and 2022.
Notably, there were two cases (Patients 4 and 5), where the endometrial
cancer had previously regressed with hormonal treatment but subsequently
recurred. In addition, Patient 1 had been treated with hormonal therapy
for twelve months without regression. This could be because the
underlying primary risk factor of obesity had not been addressed. Four
patients (80%) were diagnosed with hysteroscopy, dilatation and
endometrial curettage (HDC), and one (20%) was diagnosed using with
endometrial sampling with the Explora Device. All patients had low
grade, early-stage cancer, with endometroid as the tumor subtype. All
patients had standard staging investigations after diagnosis with CT
scan of the thorax and abdomen, as well as MRI scan of the pelvis. No
evidence of myometrial invasion, lymph node or distant metastases were
found after staging scans were performed for all patients. Patients 4
and 5 had repeat staging investigations before they were considered for
fertility sparing treatment again, after EC recurrence. Before fertility
sparing treatment was offered to all the patients, the cases were
discussed in a multidisciplinary tumor board meeting, with concurrence
from all treating specialists. All patients underwent hormonal therapy
with oral Megestrol, gonadotropin-releasing hormone agonists
(Triptorelin and Leuprolide) as well as levonorgestrel-releasing
intra-uterine device (Mirena), in accordance to the standard treatment
pathway. After starting on treatment, patients underwent HDC on three
monthly interval for surveillance. Table 2 summarizes EC disease
characteristics and hormonal therapy received.
Table 2: EC disease characteristics and hormonal therapy received.