本研究旨在评估通过保留生育能力的激素治疗 (FST) 获得完全缓解 (CR) 的早期子宫内膜样子宫内膜癌 (EC) 患者的复发危险因素。我们回顾性分析了接受 FST 的推定 IA 期患者以及两个机构的 1 级子宫内膜样 EC。同时使用甲羟孕酮（MPA）和左炔诺孕酮宫内缓释装置（LNG-IUD）。对于那些在达到 CR 后未立即尝试怀孕的患者，维持治疗包括将 LNG-IUD 维持在原位。 Cox 回归分析用于确定 CR 后无复发生存 (RFS) 的临床病理变量。在 178 名接受 FST 的子宫内膜样 EC 患者中，142 名 (79.8%) 达到 CR。达到 CR 的中位时间和中位 FST 持续时间分别为 10 个月（范围 1-34）和 14 个月（范围 3-49）。在 44 个月（范围 6-143）的中位随访期内，59.9% (85/142) 的患者出现复发，CR 后中位 RFS 为 14 个月（范围 1-123）。在多变量分析中，年龄 > 35 岁（风险比 (HR) 1.892，95% 置信区间 (CI) 1.224-2.923；P < 0.05）和第一次 CR 后怀孕（HR 0.203，95% CI 0.093-0.444；P < 0.05) 与 RFS 显着相关。年龄较大和未怀孕状态可能是 CR 后复发的危险因素。因此，患有这些疾病的患者应接受严格的随访，包括影像学和组织学检查，以检测 CR 后的复发情况。版权所有 © 2024 Elsevier Inc. 保留所有权利。

This study aimed to assess the recurrence risk factors in patients with early-stage endometrioid endometrial cancer (EC) who achieved a complete response (CR) through fertility-sparing hormonal treatment (FST).We retrospectively analyzed patients who received FST for presumed stage IA and grade 1 endometrioid EC at two institutions. Medroxyprogesterone (MPA)- and levonorgestrel-releasing intrauterine devices (LNG-IUD) were used concurrently. Maintenance therapy involved maintaining the LNG-IUDs in situ for those who did not attempt to conceive immediately after achieving CR. Cox regression analysis was used to identify clinicopathological variables for recurrence-free survival (RFS) following CR.Among 178 patients with endometrioid EC who received FST, 142 (79.8 %) achieved CR. The median time to achieve CR and the median FST duration were 10 months (range 1-34) and 14 months (range 3-49), respectively. During the median follow-up period of 44 months (range 6-143), 59.9 % (85/142) of patients had recurrence, with a median RFS of 14 months (range 1-123) after CR. In multivariable analysis, age > 35-years (hazard ratio (HR) 1.892, 95 % confidence interval (CI) 1.224-2.923; P < 0.05) and pregnancy after the first CR (HR 0.203, 95 % CI 0.093-0.444; P < 0.05) were significantly associated with RFS.Older age and non-pregnancy status may be risk factors for recurrence after CR. Therefore, patients with these conditions should undergo stringent follow-up, including imaging and histological examinations, to detect recurrence after CR.Copyright © 2024 Elsevier Inc. All rights reserved.