Effect of bariatric surgery on endometrial cancer regression as part of
fertility sparing treatment: A case series and literature review
Introduction: Obesity is a major risk factor in the development
of endometrial cancer (EC) in young patients of reproductive age.
Fertility sparing treatment is a viable option for a select group of
patients with early EC, and involves systemic and intra-uterine hormonal
therapy. Weight loss has been associated with improved outcomes in this
group. Bariatric surgery (BS) has been shown to be the most efficient
and durable method of weight loss in obese patients. However, there is a
paucity of data studying the benefit of BS as part of fertility sparing
treatment. Methods: We present a retrospective case series of
five patients who are undergoing fertility sparing treatment for early
EC, who also underwent BS for treatment of obesity and related
comorbidities. We aim to show early regression of EC for all the
patients and also report on the other health benefits of BS.
Results: All five patients in the series achieved regression of
EC within six months of undergoing BS. They also achieved significant
weight loss consistent with previous studies, and three patients who had
comorbidities related to obesity had remission of these conditions. One
of the patients with EC regression also managed to conceive with IVF.
Conclusion: Patients on fertility sparing treatment for early
EC who underwent BS was associated with early regression within 6
months, significant weight loss and resolution of comorbidities. BS
could be a promising component of fertility sparing treatment. Long
term, prospective studies are required to confirm the benefits reported
in this case series.