National Cancer Database analysis of survival after fertility-preserving hormonal therapy versus hysterectomy for early-stage endometrial cancer

As the number of young women with early-stage endometrial cancer is increasing, there is growing interest in use of progesterone-based therapy to allow fertility preservation. A cohort study using the National Cancer Database found that use of hormonal therapy for patients with clinical stage I endometrial cancer increased from 5.2% in 2004 to 13.8% in 2020 (p<0.001). There was no difference in survival between hysterectomy and hormonal therapy among patients younger than 40 years. However, among patients aged 40 to 49 years, fertility-preserving hormonal therapy was associated with a significantly increased risk of death.