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master's thesis
Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija
Zagreb: University of Zagreb, School of Medicine, 2019. urn:nbn:hr:105:351172
Vukičević, Ivana
University of Zagreb
School of Medicine
Department of Gynecology and Obstetrics

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Vukičević, I. (2019). Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:351172

Vukičević, Ivana. "Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija." Master's thesis, University of Zagreb, School of Medicine, 2019. https://urn.nsk.hr/urn:nbn:hr:105:351172

Vukičević, Ivana. "Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija." Master's thesis, University of Zagreb, School of Medicine, 2019. https://urn.nsk.hr/urn:nbn:hr:105:351172

Vukičević, I. (2019). 'Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija', Master's thesis, University of Zagreb, School of Medicine, accessed 23 November 2024, https://urn.nsk.hr/urn:nbn:hr:105:351172

Vukičević I. Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2019 [cited 2024 November 23] Available at: https://urn.nsk.hr/urn:nbn:hr:105:351172

I. Vukičević, "Očuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2019. Available at: https://urn.nsk.hr/urn:nbn:hr:105:351172

Metadata
TitleOčuvanje plodnosti liječenih od preinvazivnih lezija i raka endometrija
Title (english)Fertility-sparing treatment of preinvasive lesions and endometrial cancer
AuthorIvana Vukičević
MentorGoran Vujić (mentor)
Committee memberRatko Matijević (predsjednik povjerenstva)
Committee memberDinka Pavičić Baldani (član povjerenstva)
Committee memberGoran Vujić (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Gynecology and Obstetrics)
Zagreb
Defense date and country2019-07-12, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Gynecology and Obstetrics
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Oncology
Abstract
Rak endometrija jedan je od najčešćih ginekoloških karcinoma, s preko 380000 dijagnosticiranih slučajeva 2018. godine u svijetu. Dok se većina slučajeva dijagnosticira u postmenopauzalnih žena, 3-14% slučajeva dijagnosticira se u žena mlađih od 40 godina. Naime, povećanjem incidencije rizičnih faktora među mlađim ženama, kao što su pretilost i anovulacijska stanja, raste incidencija raka endometrija u toj dobnoj skupini. Mnoge žene u reproduktivnoj dobi žele očuvati plodnost i ostvariti trudnoću, zbog čega standardni postupak histerektomije i obostrane salpingoovarijektomije nije prihvatljiva metoda. U tim slučajevima, razmatra se konzervativno liječenje u svrhu očuvanja plodnosti. Konzervativno liječenje preinvazivnih lezija i raka endometrija u žena koje žele očuvati plodnost je učinkovita i sigurna metoda za pacijentice sa složenom atipičnom hiperplazijom i dobro diferenciranim endometrioidnim tipom raka endometrija ranog stadija, sa dokazanim odsustvom invazije miometrija i širenja bolesti izvan maternice. Najčešće korištena vrsta terapije je terapija sintetskim progesteronima, progestinima. Međutim, ne postoji određena optimalna doza i trajanje terapije progestinima. Praćenje pacijentica tijekom liječenja preporučuje se provoditi histološkom analizom endometrija svaka 3 mjeseca do postizanja potpunog odgovora. Uzevši u obzir visoku stopu povratka bolesti, preporuča se pokušati ostvariti trudnoću odmah nakon postizanja potpunog odgovora na liječenje te učiniti histerektomiju nakon uspješne trudnoće. U najvećem broju slučajeva trudnoća se ostvaruje uz metode medicinski potpomognute oplodnje.
Abstract (english)
Endometrial cancer is one of the most common gynecologic cancers, with over 380000 cases diagnosed worldwide in 2018. While most of the cases are diagnosed in postmenopausal women, 3-14% cases are diagnosed in women under 40 years of age. Given the rising incidence of risk factors such as obesity and anovulatory conditions among younger women, the incidence of endometrial cancer is increasing in that age group. Many women want to preserve fertility and achieve pregnancy wherefore standard treatment of hysterectomy and bilateral salpingo-oophorectomy is not acceptable method. In that cases, conservative, fertility-sparing treatment should be considered. Fertility-sparing treatment of preinvasive lesions and endometrial cancer is safe and effective option for patients with complex atypical hyperplasia and well-differentiated, early-stage, endometrioid type endometrial cancer, with no evidence of myometrial invasion and extrauterine spread of disease. Progestin therapy, made of synthetic progesterone, is the most commonly used type of therapy. However, optimal dose and duration of progestin therapy is not determined. Recommended surveillance during treatment includes histopathological analysis of endometrium every 3 months until complete response is achieved. Considering the high rate of disease recurrence, patients are recommended to promptly attempt pregnancy following complete response to treatment and undergo hysterectomy after successful pregnancy. In a majority of cases, pregnancy is achieved by assisted reproductive technologies.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:351172
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2020-03-06 12:35:27