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Endometrial Cancer — SCE Medical Oncology MCQ

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HardGynaecological CancersEndometrial CancerSCE Medical Oncology

A 48-year-old woman with FIGO stage IA grade 1 endometrioid endometrial cancer desires fertility preservation. She has not had children. What management approach may be considered?

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Correct answer: C — Conservative management with high-dose progestogen (medroxyprogesterone acetate or levonorgestrel IUS) with close endometrial surveillance

For selected young women with stage IA grade 1 endometrioid endometrial cancer who wish to preserve fertility, conservative hormonal management with high-dose progestogen (oral MPA 400-600 mg/day or levonorgestrel-releasing intrauterine system) can achieve complete response in approximately 70% of cases. This requires: confirmed grade 1 endometrioid histology, no myometrial invasion on MRI, no contraindications to progestogen, and regular endometrial sampling (every 3-6 months). Definitive surgery is recommended after childbearing.

Reference: ESMO 2024 Endometrial Cancer Guidelines; NICE NG Gynaecological cancers pathway