Objective: The purpose of this review is to evaluate the risk factors for endometrial cancer in young women as well as fertility preservation options. Design: A literature search using the key words fertility preservation, endometrial cancer, uterine cancer, and risk factors was conducted in MEDLINE,® EMBASE, and the Cochrane Database of Systematic Reviews. Results: Etiologic factors for development of endometrial cancer were discussed. All available conservative options to avoid hysterectomy were also discussed. Treatment outcome for young women with endometrial cancer treated by systemic progestins was summarized. Conclusions: In women with early stage well-differentiated endometrial cancer, conservative treatment with progestins should be considered. It is important to note that this is a temporary treatment that has to be followed by a definitive treatment after completion of the patient's family. Proper counseling and close follow-up are mandatory. Because of the rarity of the disease in young women, a multicenter trial or a registry is needed. Another issue is to identify which group of patients will respond to progestin therapy, perhaps by molecular and gene analysis. (J GYNECOL SURG 28:280)
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