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.