Ultrasound and Histology in AEH and Early EEC Treated Conservatively

NCT ID: NCT07028242

Last Updated: 2025-06-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-06-11

Study Completion Date

2027-06-30

Brief Summary

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Ultra-S.A.F.E. is a multicenter, ambispective observational study investigating the ultrasound and histological characteristics of patients with atypical endometrial hyperplasia (AEH) or endometrioid endometrial carcinoma (EEC) G1-2 undergoing fertility-sparing treatment (FST). The study aims to describe pre-treatment ultrasound features, evaluate endometrial modifications during treatment, and assess histological and reproductive outcomes. It includes a prospective cohort (new patients recruited at three gynecologic oncology centers) and a retrospective cohort (patients treated conservatively since January 2023). Approximately 50 patients will be enrolled over 24 months, with clinical, ultrasound, and histological data collected. The ultimate goal is to enhance the diagnostic and monitoring role of transvaginal ultrasound (TVUS) in conservative treatment for fertility preservation.

Detailed Description

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Conditions

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Fertility-Sparing Treatment (FST) Atypical Endometrial Hyperplasia Early Endometrial Cancer (EEC)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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Retrospective

This group includes patients with a histological diagnosis of atypical endometrial hyperplasia (AEH) or endometrioid endometrial carcinoma (EEC) G1-G2 who underwent hysteroscopic fertility-sparing surgery and medical treatment starting from January 2023. These patients were retrospectively identified from the Hysteroscopic Treatments Database. Only those with pre-treatment transvaginal ultrasound imaging available were included.

Hysteroscopic fertility-sparing surgery and hormonal treatment

Intervention Type PROCEDURE

Patients undergo hysteroscopic endometrial resection using the Mazzon "three-step" technique or tissue removal device (TRD), depending on the lesion type. Following surgery, hormonal treatment is administered either via intrauterine device (IUD) or oral progestin. Monitoring includes serial endometrial biopsies and transvaginal ultrasounds at 3, 6, and 12 months.

Prospective

This group includes reproductive-age women newly diagnosed with AEH or EEC G1-G2, confirmed by endometrial biopsy during diagnostic hysteroscopy, who are eligible and consenting for fertility-sparing treatment. Patients undergo baseline clinical assessment, transvaginal ultrasound, and MRI prior to hysteroscopic surgery. Fertility-sparing treatment includes hysteroscopic endometrial resection, intrauterine device (IUD) placement and/or oral progestin therapy, followed by monitoring with serial biopsies and ultrasound at 3, 6, and 12 months.

Hysteroscopic fertility-sparing surgery and hormonal treatment

Intervention Type PROCEDURE

Patients undergo hysteroscopic endometrial resection using the Mazzon "three-step" technique or tissue removal device (TRD), depending on the lesion type. Following surgery, hormonal treatment is administered either via intrauterine device (IUD) or oral progestin. Monitoring includes serial endometrial biopsies and transvaginal ultrasounds at 3, 6, and 12 months.

Interventions

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Hysteroscopic fertility-sparing surgery and hormonal treatment

Patients undergo hysteroscopic endometrial resection using the Mazzon "three-step" technique or tissue removal device (TRD), depending on the lesion type. Following surgery, hormonal treatment is administered either via intrauterine device (IUD) or oral progestin. Monitoring includes serial endometrial biopsies and transvaginal ultrasounds at 3, 6, and 12 months.

Intervention Type PROCEDURE

Other Intervention Names

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Endometrial resection Hormonal therapy Intrauterine device (IUD) placement Oral progestin therapy

Eligibility Criteria

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Inclusion Criteria

Women aged 18-45 years.

Histologically confirmed atypical endometrial hyperplasia (AEH) or endometrioid endometrial carcinoma (EEC) G1-2.

Candidates for fertility-sparing treatment (hysteroscopic resection and/or progestin therapy).

No prior history of invasive endometrial carcinoma.

Adequate endometrial visualization via transvaginal ultrasound (TVUS) and/or MRI.

Signed informed consent for study participation.

Exclusion Criteria

Women under 18 or over 45 years.

Presence of myometrial invasion on MRI or histological analysis.

Histological diagnosis of serous carcinoma, clear cell carcinoma, or undifferentiated carcinoma.

History of previous hysterectomy or non-conservative surgical treatment.

Contraindications to hormonal therapy (e.g., thromboembolic disease, hormone-dependent malignancies).

Pregnancy at the time of enrollment.

Lack of adequate imaging for ultrasound-based assessment.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Fondazione Policlinico Universitario Agostino Gemelli IRCCS

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Antonia Carla Testa

Role: PRINCIPAL_INVESTIGATOR

Fondazione Policlinico Universitario Agostino Gemelli

Locations

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Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Roma, , Italy

Site Status

Countries

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Italy

Central Contacts

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Antonia Carla Testa

Role: CONTACT

0630156399

Federica Pozzati

Role: CONTACT

0630156399

Other Identifiers

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7691

Identifier Type: -

Identifier Source: org_study_id

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