{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:50:19Z","timestamp":1790351419920,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH 114\u2010S0201"],"award-info":[{"award-number":["NTUH 114\u2010S0201"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Fertility\u2010sparing treatments using oral progestins have demonstrated promising oncologic outcomes for endometrial intraepithelial neoplasia and early\u2010stage endometrial cancer. However, the high recurrence rate remains a major concern, and the literature on long\u2010term follow\u2010up outcomes is limited. This study aimed to identify recurrence risk factors by analyzing clinicopathological and molecular profiles in a cohort with a median follow\u2010up of 9\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This retrospective study included patients under 45\u2009years of age who were diagnosed with endometrial intraepithelial neoplasia or endometrial cancer and received fertility\u2010sparing treatments at our center between 2010 and 2021. Patients who achieved complete responses were categorized according to recurrence status. Demographic, clinical, and molecular data were compared between groups. The primary endpoint was to identify risk factors for recurrence; secondary endpoints assessed obstetric and oncologic outcomes in patients with relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 40 patients, 8 underwent hysterectomy within 1.5\u2009years, while 32 responded to treatment and continued follow\u2010up. The recurrence and non\u2010recurrence groups contained 20 and 12 patients, respectively, with a median follow\u2010up of 107.5\u2009months (range, 35\u2013175\u2009months). Multivariate analysis showed that a family history of cancer (HR\u2009=\u20092.597, <jats:italic>p<\/jats:italic>\u2009=\u20090.039) and treatment with megestrol acetate as the initial therapy (HR\u2009=\u20093.130, <jats:italic>p<\/jats:italic>\u2009=\u20090.021) were independent risk factors for shorter time to recurrence. Although mismatch repair deficiency was positively correlated with recurrence, the association did not reach statistical significance (<jats:italic>p<\/jats:italic>\u2009=\u20090.057). Four out of 24 patients were upstaged after hysterectomy, and all were in the recurrence group. Nine patients (22.5%) achieved pregnancy, with three successfully conceiving after achieving complete response following retreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with long\u2010term follow\u2010up after fertility\u2010sparing treatment, a family history of cancer and initial treatment with megestrol acetate were significantly associated with recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.70028","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T04:03:36Z","timestamp":1755662616000},"page":"1994-2005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long\u2010term outcomes of fertility\u2010sparing treatment in endometrial carcinoma and endometrial intraepithelial neoplasia: Recurrence risk factors over a 9\u2010year follow\u2010up"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7902-3730","authenticated-orcid":false,"given":"Ya\u2010Ting","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology National Taiwan University Hospital  Taipei Taiwan"},{"name":"Graduate Institute of Clinical Medicine National Taiwan University College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6817-0693","authenticated-orcid":false,"given":"Heng\u2010Cheng","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Yi","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Taiwan University Hospital Hsin\u2010Chu Branch  Hsin\u2010Chu City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u2010Ting","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4903-7878","authenticated-orcid":false,"given":"Chi\u2010Hau","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02535-5"},{"key":"e_1_2_14_3_1","unstructured":"Taiwan Ministry of Health and Welfare. 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