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Effect of bariatric surgery on endometrial cancer regression as part of fertility sparing treatment: A case series and literature review
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  • Jinlin Lin,
  • Weng Yan Ho,
  • Qi Xuan Lim,
  • Hui Xian Felicia Chin
Jinlin Lin
Changi General Hospital Department of General Surgery

Corresponding Author:[email protected]

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Weng Yan Ho
KK Women's and Children's Hospital
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Qi Xuan Lim
Changi General Hospital Department of General Surgery
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Hui Xian Felicia Chin
KK Women's and Children's Hospital
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Abstract

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.
27 Mar 2023Submitted to Cancer Reports
29 Mar 2023Submission Checks Completed
29 Mar 2023Assigned to Editor
29 Mar 2023Review(s) Completed, Editorial Evaluation Pending
29 Mar 2023Editorial Decision: Revise Major
01 Apr 20231st Revision Received
04 Apr 2023Submission Checks Completed
04 Apr 2023Assigned to Editor
04 Apr 2023Review(s) Completed, Editorial Evaluation Pending
04 Apr 2023Reviewer(s) Assigned
08 May 2023Editorial Decision: Revise Major
18 May 20232nd Revision Received
24 May 2023Submission Checks Completed
24 May 2023Assigned to Editor
24 May 2023Review(s) Completed, Editorial Evaluation Pending
24 May 2023Reviewer(s) Assigned
05 Jun 2023Editorial Decision: Revise Minor
12 Jun 20233rd Revision Received
14 Jun 2023Submission Checks Completed
14 Jun 2023Assigned to Editor
14 Jun 2023Review(s) Completed, Editorial Evaluation Pending
26 Jun 2023Editorial Decision: Accept