SHAPE-ENDO:肥満と早期子宮内膜癌患者におけるマルチモーダル術前最適化 (SHAPE-ENDO)
SHAPE-ENDO(セマグルチド+ホルモン療法およびプレハビリテーションによる子宮体がん治療):非定型子宮内膜増殖症または早期子宮体がんおよびBMI≥35の患者における代謝および手術最適化のための前向き観察研究。
SHAPE-ENDOは、肥満(BMI≥35)かつ非定型子宮内膜増殖症または早期子宮内膜がんを有する女性に対する多様式術前最適化戦略を評価するために、オスピタル・ウニベルシタリ・デ・ベルビゲで実施された前向き観察研究です。参加者は、セマグルチド療法、レボノルゲストレル子宮内避妊器具(経口プロゲスチン併用または非併用)、構造化された栄養および運動プログラム、定期的な子宮内膜サーベイランスを含む標準的ケア介入を受けます。
本研究は、この多様式戦略が代謝的健康を改善し、体重減少を促進し、最適化期間中の腫瘍学的安全性を維持しながら低侵襲手術の適応を増加させるかどうかを評価することを目的としています。
参加者は6~12ヶ月間追跡され、人体計測および代謝パラメータ、組織学的反応、生活の質、治療遵守状況がモニタリングされます。すべての介入は日常的な臨床ケアの一部です。本研究の結果は、肥満および早期子宮内膜がん患者における代謝最適化戦略を評価する将来の比較試験に情報を提供する可能性があります。
調査の概要
状態
詳細な説明
肥満は子宮内膜癌の主要なリスク因子であり、手術の複雑さの増加、周術期罹病率、および低侵襲手術の適格性の低下と関連しています。 重度の肥満患者では、死亡率はしばしば癌の進行ではなく代謝性併存疾患によって影響を受けます。 したがって、手術前に代謝的健康と機能的状態を改善することを目的とした戦略は、重要な臨床的意義を持つ可能性があります。
レボノルゲストレル放出子宮内避妊器具や全身性プロゲスチンなどのホルモン療法は、非定型子宮内膜過形成または早期子宮内膜癌の選択された患者において疾患コントロールのために一般的に使用されています。 並行して、セマグルチドを含むグルカゴン様ペプチド-1受容体作動薬は、著しい体重減少と心臓代謝的利点を示しています。 薬物療法、栄養最適化、および構造化された運動プログラムを組み合わせた多様式プレハビリテーションアプローチは、手術準備状態と全体的な健康状態を改善する可能性があります。
SHAPE-ENDOは、Hospital Universitari de Bellvitgeで実施されている前向き観察コホート研究です。 この研究は、セマグルチドによる薬理学的体重管理、レボノルゲストレル子宮内避妊器具(経口プロゲスチン併用または非併用)によるホルモン性子宮内膜治療、および監督付き食事カウンセリングと運動プログラムを含む生活習慣介入を含む多様式術前最適化戦略を評価します。 患者は、通常の臨床診療に従って代謝モニタリング、画像検査、および子宮内膜サンプリングを伴う定期的な臨床フォローアップを受けます。
本研究は、肥満および早期子宮内膜疾患を有する女性におけるこの多様式最適化戦略の実現可能性と臨床的影響を評価することを目的としています。 アウトカムには、代謝的および人体計測的変化、組織学的反応、生活の質、および低侵襲手術の適格性が含まれます。 データは、電子カルテ、臨床検査、画像検査、および妥当性が確認された患者報告アウトカム質問票を通じて収集されます。 この研究は、施設の倫理委員会によって承認されており、標準的ケア介入のみを含みます。
研究の種類
入学 (推定)
段階
- フェーズ 4
連絡先と場所
研究連絡先
- 名前:Jorge Garcia Fernandez, MD
- 電話番号:+34 622595644
- メール:jorgarciafernan@gmail.com
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
調査対象母集団
説明
対象基準:
- 18歳以上の女性。
- 組織学的に確認された異型子宮内膜増殖症/EIN、または子宮体部に限局した低リスク子宮内膜様子宮内膜癌(G1-G2)。
- ESGO-ESTRO-ESP 2025に基づく低/中リスク分類;術前病期IA1、IA2、またはIB。
- 陰性または限局性の脈管侵襲(可能な場合)。
- 分子サブグループ:POLEmut、p53wt、MMRd、またはNSMP ER+。
- 登録時BMI ≥35 kg/m²。
- 一時的な保存的治療を受け入れ、多様式最適化戦略に従えること。
- インフォームド・コンセントを理解し署名できること。
除外基準:
- FIGO病期IA3、IC、II以上。
- 陽性の脈管侵襲。
- 高リスク分子:p53mutまたはNSMP ER陰性。
- 非子宮内膜様組織型(漿液性、明細胞、癌肉腫、混合型など)。
- 転移性または子宮外疾患。
- GLP-1RAまたはプロゲスチンへの禁忌。
- 既往の膵炎、MEN-2、甲状腺髄様癌。
- 他の薬剤臨床試験への参加。
- 研究者の判断により安全性または遵守性を損なう状態。
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ:Arm A - Standard Immediate Surgery
Participants randomized to the control arm will undergo standard immediate surgical treatment according to the institutional protocol of Hospital Universitari de Bellvitge. Surgery will usually include hysterectomy with bilateral salpingo-oophorectomy, sentinel lymph node assessment when indicated and feasible, and minimally invasive or robotic approach whenever technically possible according to clinical judgment. Intervention: Procedure/Surgery - Standard Immediate Surgery Standard surgical management according to institutional practice for atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or early-stage low-risk endometrioid endometrial cancer. Perioperative outcomes, surgical approach, conversion to laparotomy, estimated blood loss, operative time, hospital stay, transfusion, sentinel lymph node detection, intraoperative complications, and 30-day postoperative complications graded according to Clavien-Dindo will be recorded. |
Standard surgical treatment according to the institutional protocol of Hospital Universitari de Bellvitge for atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or early-stage low-risk endometrioid endometrial cancer.
Surgery will usually include hysterectomy with bilateral salpingo-oophorectomy, sentinel lymph node assessment when indicated and feasible, and a minimally invasive or robotic approach whenever technically possible according to clinical judgment.
Surgical approach, operative time, estimated blood loss, conversion to laparotomy, transfusion, hospital stay, intraoperative complications, 30-day postoperative complications, readmission, and sentinel lymph node detection will be recorded.
他の名前:
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実験的:Arm B - Experimental: SHAPE-ENDO Multimodal Strategy Before Surgery
Participants randomized to the experimental arm will receive the SHAPE-ENDO multimodal pre-surgical optimization strategy before surgery. The strategy includes semaglutide/Wegovy®, levonorgestrel-releasing intrauterine device/Mirena® with or without oral medroxyprogesterone acetate/Progevera®, structured nutritional intervention, adapted physical exercise, and scheduled oncologic surveillance. The strategy will last 28 weeks initially and may be extended up to 54 weeks if there is clinical, metabolic, or anthropometric benefit, adequate tolerance, and no tumor progression. Intervention: Drug - Semaglutide / Wegovy® Weekly subcutaneous semaglutide administered according to approved labeling, clinical indication, tolerance, and endocrinology assessment, with standard dose escalation up to the tolerated therapeutic dose. Dose, adherence, tolerability, adverse events, and reasons for dose modification or discontinuation will be recorded. Intervention: Device - Levonorgestrel-Releasing I |
標準的な肥満および代謝管理の一環として、臨床栄養チームが監視する個別化された低カロリー食事計画。
このプログラムには、基礎代謝要件に基づくカロリー制限が含まれ、選択された症例では4〜6週間の超低カロリー食(VLCD)のオプションがあります。
定期的な外来診察でフォローアップが行われ、体重、BMI、ウエスト周囲長、および遵守状況が記録されます。
この介入は日常的な臨床ケアの一部であり、実験的に割り当てられるものではありません。結果は前向きに記録されます。
他の名前:
機能的能力、有酸素耐性、および手術適性を改善するために設計された構造化された身体運動プログラム。
このプログラムには、有酸素運動と筋力トレーニングを組み合わせた、週1回の監督付きまたは半監督付きセッションが含まれ、通常は週3回、30〜45分間、ベースラインのパフォーマンスに合わせて調整されます。
この介入は、外科的準備を受ける肥満患者に対する通常の臨床ケアの一部であり、実験的に割り当てられるものではありません。
遵守状況、耐性、および機能的結果に関するデータは前向きに収集されます。
他の名前:
ベースラインおよび追跡期間(通常は14週および28-54週)に実施される組織学的サーベイランススケジュールにより、完全奏功、安定、または進行を含む局所腫瘍状態を評価する。
手順には、臨床適応に基づく子宮鏡検査を選択的に行う外来子宮内膜生検が含まれる。
これらの評価は、異型子宮内膜増殖症または早期子宮内膜様癌に対して保存的に管理される患者における標準臨床ケアの一部を構成し、実験的に割り当てられるものではない。
疾患の経過および手術適格性を評価するために、データは前向きに記録される。
他の名前:
骨盤MRIと経腟超音波を用いた放射線学的評価は、子宮疾患、筋層浸潤、付属器の状態、および治療反応を評価するための日常的な臨床ケアの一部として実施されます。
画像診断は通常、ベースラインでステージングを確認するため、および臨床的に適応がある場合のフォローアップ時に実施されます。
これらの画像診断モダリティは標準的な臨床ガイドラインに従って使用され、実験的に割り当てられるものではありません。結果は、疾患の安定性と手術計画を評価するために前向きに収集されます。
他の名前:
Weekly subcutaneous semaglutide/GLP-1 receptor agonist therapy administered according to approved labeling, clinical indication, patient tolerance, and endocrinology assessment, with standard dose escalation up to the tolerated therapeutic dose.
The intervention is used for weight loss and metabolic optimization in participants with severe obesity.
Dose, adherence, tolerability, and reasons for dose modification or discontinuation will be recorded prospectively.
他の名前:
Local hormonal therapy using a 52-mg levonorgestrel-releasing intrauterine system placed at baseline or within 14 days after baseline, with ultrasound confirmation of correct placement.
The LNG-IUD is used within the protocolized SHAPE-ENDO strategy according to clinical indication, approved labeling, current guidelines, and physician judgment, for local disease control in atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or early-stage, low-risk endometrioid endometrial cancer.
Tolerability, continuation, adverse events, and local histological response will be recorded prospectively.
他の名前:
Systemic hormonal therapy prescribed according to clinical criteria to support local disease control in atypical endometrial hyperplasia or early-stage endometrioid carcinoma.
Typical regimens include medroxyprogesterone acetate (400-600 mg/day) or megestrol acetate (160-320 mg/day).
Therapy is initiated or escalated when indicated based on tumor burden or suboptimal response to LNG-IUD.
Oral progestins may be used within the protocolized SHAPE-ENDO strategy according to clinical indication, approved labeling, current guidelines, and physician judgment.
Use, dosing, tolerance, and outcomes will be recorded prospectively.
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Recruitment Rate
時間枠:From study opening to end of recruitment, up to 36 months.
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Number of participants enrolled per month during the active recruitment period.
This outcome will assess the feasibility of recruiting eligible participants with atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or low-risk endometrioid endometrial cancer and BMI ≥40 kg/m² into a pilot randomized clinical trial.
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From study opening to end of recruitment, up to 36 months.
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Acceptance of Randomization Rate
時間枠:At baseline, before randomization.
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Proportion of eligible participants who agree to participate in the trial and accept random assignment to either standard immediate surgery or the SHAPE-ENDO multimodal pre-surgical optimization strategy.
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At baseline, before randomization.
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Participant Retention Rate
時間枠:From randomization to surgery and 30 days postoperatively, up to 14 months.
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Proportion of randomized participants who complete the planned follow-up required for the main pilot analysis, including surgical treatment and 30-day postoperative assessment, or completion of the assigned intervention period when applicable.
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From randomization to surgery and 30 days postoperatively, up to 14 months.
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Adherence to the Assigned Intervention
時間枠:From randomization to surgery and 30 days postoperatively, up to 14 months.
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Proportion of randomized participants who comply with the main procedures planned in their assigned arm.
In the control arm, this includes undergoing standard immediate surgery and postoperative follow-up.
In the SHAPE-ENDO arm, this includes adherence to the multimodal strategy, scheduled visits, oncologic surveillance, and planned reassessment.
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From randomization to surgery and 30 days postoperatively, up to 14 months.
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Completion of the SHAPE-ENDO Multimodal Strategy
時間枠:From randomization to week 28 or week 54.
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Proportion of participants randomized to the SHAPE-ENDO arm who complete the planned multimodal pre-surgical optimization strategy until the week 28 reassessment and, when applicable, until week 54.
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From randomization to week 28 or week 54.
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Proportion of SHAPE-ENDO Participants Reaching Surgery Without Tumor Progression
時間枠:From randomization to surgery, up to 54 weeks.
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Proportion of participants randomized to the SHAPE-ENDO arm who undergo surgery after the pre-surgical optimization period without histological, radiological, or clinical evidence of tumor progression.
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From randomization to surgery, up to 54 weeks.
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Incidence of Serious Adverse Events, Tumor Progression, and Study Discontinuation
時間枠:From randomization to surgery and 30 days postoperatively, up to 14 months.
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Frequency of serious adverse events, tumor progression during the optimization period, and reasons for discontinuation or withdrawal from the study.
Adverse events will be recorded prospectively and classified according to CTCAE v5.0 when applicable.
These events will be described overall and by randomized arm when applicable.
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From randomization to surgery and 30 days postoperatively, up to 14 months.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Perioperative Morbidity
時間枠:At surgery and up to 30 days postoperatively.
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Proportion of participants with intraoperative complications and/or clinically relevant postoperative complications within 30 days after surgery, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
Postoperative complications will be classified according to the Clavien-Dindo classification, with clinically relevant complications defined as Clavien-Dindo grade ≥II
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At surgery and up to 30 days postoperatively.
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Surgical Approach
時間枠:At surgery.
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Proportion of participants undergoing minimally invasive surgery, robotic surgery, conventional laparoscopy, or laparotomy, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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At surgery.
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Conversion to Laparotomy
時間枠:At surgery.
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Proportion of participants requiring conversion from minimally invasive surgery to laparotomy, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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At surgery.
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Operative Time
時間枠:At surgery.
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Duration of surgery measured in minutes, from skin incision to skin closure, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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At surgery.
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Estimated Blood Loss
時間枠:At surgery.
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Estimated intraoperative blood loss measured in milliliters, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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At surgery.
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Length of Hospital Stay
時間枠:From surgery to hospital discharge, up to 30 days.
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Number of days from surgery to hospital discharge, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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From surgery to hospital discharge, up to 30 days.
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Need for Blood Transfusion
時間枠:At surgery and up to 30 days postoperatively.
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Proportion of participants requiring perioperative blood transfusion, compared between the standard immediate surgery arm and the SHAPE-ENDO arm
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At surgery and up to 30 days postoperatively.
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Sentinel Lymph Node Detection Rate
時間枠:At surgery.
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Proportion of participants in whom sentinel lymph node mapping is successful, including unilateral and bilateral detection rates when sentinel lymph node assessment is performed.
Detection rates will be described and compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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At surgery.
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Histological Response in the SHAPE-ENDO Arm
時間枠:Baseline to week 14, week 28, and, if applicable, week 54.
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Proportion of participants in the SHAPE-ENDO arm with complete response, stable disease, or tumor progression during the pre-surgical optimization period.
Complete response is defined as absence of endometrioid carcinoma or atypical hyperplasia in endometrial biopsy.
Stable disease is defined as persistence of the lesion without progression in grade or stage.
Progression is defined as progression from atypical endometrial hyperplasia/endometrial intraepithelial neoplasia to endometrioid endometrial carcinoma, increase to grade 3, high-risk histology, or extension beyond the uterine corpus.
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Baseline to week 14, week 28, and, if applicable, week 54.
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Time to Optimization in the SHAPE-ENDO Arm
時間枠:From randomization to week 28 or week 54
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Time from randomization to multidisciplinary committee decision indicating that sufficient clinical, metabolic, anthropometric, and oncologic optimization has been achieved to proceed to surgery.
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From randomization to week 28 or week 54
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Rate of Surgery After SHAPE-ENDO Optimization
時間枠:From randomization to surgery, up to 54 weeks.
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Proportion of participants randomized to the SHAPE-ENDO arm who undergo surgery after the pre-surgical optimization strategy.
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From randomization to surgery, up to 54 weeks.
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Change in Glycated Hemoglobin
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in glycated hemoglobin, measured as HbA1c percentage using standard clinical laboratory assays.
Changes over time will be described within each arm and compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
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Baseline to 6 months and baseline to 12 months.
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Change in Fasting Plasma Glucose
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in fasting plasma glucose concentration, measured in mg/dL using standard laboratory assays.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in Insulinemia and HOMA-IR
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in fasting insulin concentration and HOMA-IR, when available.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in FIB-4 Index
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in fibrosis-4 index, calculated using age, AST, ALT, and platelet count.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in Lipid Profile
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in triglycerides, LDL cholesterol, and HDL cholesterol measured using standard laboratory lipid panel testing.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in Blood Pressure
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in systolic and diastolic blood pressure, measured in mmHg during scheduled clinical visits.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in C-Reactive Protein
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in serum C-reactive protein concentration, measured in mg/L using standard laboratory assays.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in Body Weight and BMI
時間枠:Baseline to 6 months and baseline to 12 months.
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Absolute and percentage change from baseline in body weight and body mass index.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in Waist Circumference
時間枠:Baseline to 6 months and baseline to 12 months.
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Change from baseline in waist circumference, measured in centimeters.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months and baseline to 12 months.
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Change in Visceral Adiposity by MRI
時間枠:Baseline to week 28 and, if applicable, week 54.
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Absolute and percentage change from baseline in visceral adiposity measured by pelvic MRI according to the predefined radiologic measurement protocol.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to week 28 and, if applicable, week 54.
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Change in Body Composition by Bioelectrical Impedance Analysis
時間枠:Baseline to week 28 and, if applicable, week 54.
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Change from baseline in body composition parameters measured by bioelectrical impedance analysis.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to week 28 and, if applicable, week 54.
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Change in Health-Related Quality of Life Score - SF-36
時間枠:Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
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Change from baseline in health-related quality of life assessed using the Short Form-36 Health Survey.
Scores range from 0 to 100, with higher scores indicating better health-related quality of life.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
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Change in Quality of Life Score - EORTC QLQ-C30
時間枠:Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
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Change from baseline in quality of life assessed using the EORTC QLQ-C30 questionnaire.
Scores range from 0 to 100 according to EORTC scoring guidelines.
Changes over time will be described within each arm and compared between both randomized arms.
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Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
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Overall Survival
時間枠:From randomization up to 5 years.
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Time from randomization to death from any cause.
Participants alive at the end of follow-up will be censored at the date of last contact.
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From randomization up to 5 years.
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Cancer-Specific Survival
時間枠:From randomization up to 5 years.
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Time from randomization to death from endometrial cancer.
Participants alive or deceased from causes unrelated to endometrial cancer will be censored according to the statistical analysis plan.
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From randomization up to 5 years.
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Recurrence-Free Survival
時間枠:From randomization up to 5 years.
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Time from randomization to first documented recurrence of endometrial cancer.
Recurrence may be defined by histological, radiological, or clinical evidence according to standard follow-up criteria.
Participants without recurrence will be censored at the date of last available follow-up.
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From randomization up to 5 years.
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協力者と研究者
捜査官
- 主任研究者:Jorge Garcia Fernandez、Hospital Universitari de Bellvitge
- 主任研究者:Lola Marti、Hospital Universitari de Bellvitge
出版物と役立つリンク
一般刊行物
- Minnella EM, Awasthi R, Loiselle SE, Agnihotram RV, Ferri LE, Carli F. Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial. JAMA Surg. 2018 Dec 1;153(12):1081-1089. doi: 10.1001/jamasurg.2018.1645.
- Concin N, Matias-Guiu X, Vergote I, Cibula D, Mirza MR, Marnitz S, Ledermann J, Bosse T, Chargari C, Fagotti A, Fotopoulou C, Gonzalez Martin A, Lax S, Lorusso D, Marth C, Morice P, Nout RA, O'Donnell D, Querleu D, Raspollini MR, Sehouli J, Sturdza A, Taylor A, Westermann A, Wimberger P, Colombo N, Planchamp F, Creutzberg CL. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021 Jan;31(1):12-39. doi: 10.1136/ijgc-2020-002230. Epub 2020 Dec 18.
- Davies M, Faerch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I; STEP 2 Study Group. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 Mar 13;397(10278):971-984. doi: 10.1016/S0140-6736(21)00213-0. Epub 2021 Mar 2.
- Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, Lingvay I, Mosenzon O, Rosenstock J, Rubio MA, Rudofsky G, Tadayon S, Wadden TA, Dicker D; STEP 4 Investigators. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1414-1425. doi: 10.1001/jama.2021.3224.
- Akesson A, Wolmesjo N, Adok C, Milsom I, Dahm-Kahler P. Lymphadenectomy, obesity and open surgery are associated with surgical complications in endometrial cancer. Eur J Surg Oncol. 2021 Nov;47(11):2907-2914. doi: 10.1016/j.ejso.2021.06.034. Epub 2021 Jul 1.
- Iavazzo C, Gkegkes ID. Conservative management of patients with endometrial intraepithelial neoplasia (EIN): Factors that could affect response and pregnancy rates. Turk J Med Sci. 2022 Jun;52(3):870. doi: 10.55730/1300-0144.5384. Epub 2022 Jun 16. No abstract available.
- Cui J, Zhao YC, She LZ, Wang TJ. Comparative effects of progestin-based combination therapy for endometrial cancer or atypical endometrial hyperplasia: a systematic review and network meta-analysis. Front Oncol. 2024 May 3;14:1391546. doi: 10.3389/fonc.2024.1391546. eCollection 2024.
- Laurelli G, Falcone F, Gallo MS, Scala F, Losito S, Granata V, Cascella M, Greggi S. Long-Term Oncologic and Reproductive Outcomes in Young Women With Early Endometrial Cancer Conservatively Treated: A Prospective Study and Literature Update. Int J Gynecol Cancer. 2016 Nov;26(9):1650-1657. doi: 10.1097/IGC.0000000000000825.
- Fan Z, Li H, Hu R, Liu Y, Liu X, Gu L. Fertility-Preserving Treatment in Young Women With Grade 1 Presumed Stage IA Endometrial Adenocarcinoma: A Meta-Analysis. Int J Gynecol Cancer. 2018 Feb;28(2):385-393. doi: 10.1097/IGC.0000000000001164.
- Marnach ML, Butler KA, Henry MR, Hutz CE, Langstraat CL, Lohse CM, Casey PM. Oral Progestogens Versus Levonorgestrel-Releasing Intrauterine System for Treatment of Endometrial Intraepithelial Neoplasia<sup/> J Womens Health (Larchmt). 2017 Apr;26(4):368-373. doi: 10.1089/jwh.2016.5774. Epub 2016 Nov 30.
- Bourou MZ, Matsas A, Valsamakis G, Vlahos N, Panoskaltsis T. The Potential Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists as a Type of Conservative Treatment of Endometrial Cancer in Women of Reproductive Age: A Review of the Literature and a Call for Study. Cureus. 2024 Sep 18;16(9):e69678. doi: 10.7759/cureus.69678. eCollection 2024 Sep.
- Toliver JC, Divino V, Ng CD, Wang J. Real-World Weight Loss Among Patients Initiating Semaglutide 2.4 mg and Enrolled in WeGoTogether, a Digital Self-Support Application. Adv Ther. 2025 Oct;42(10):5010-5022. doi: 10.1007/s12325-025-03325-1. Epub 2025 Aug 6.
- Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, Jodar E, Kandler K, Rigas G, Wadden TA, Wharton S; STEP 5 Study Group. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022 Oct;28(10):2083-2091. doi: 10.1038/s41591-022-02026-4. Epub 2022 Oct 10.
- von Gruenigen VE, Tian C, Frasure H, Waggoner S, Keys H, Barakat RR. Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma : a Gynecologic Oncology Group study. Cancer. 2006 Dec 15;107(12):2786-91. doi: 10.1002/cncr.22351.
- Vargiu V, Rosati A, Capozzi VA, Sozzi G, Gioe A, Berretta R, Chiantera V, Scambia G, Fanfani F, Cosentino F. Impact of Obesity on Sentinel Lymph Node Mapping in Patients with apparent Early-Stage Endometrial Cancer: The ObeLyX study. Gynecol Oncol. 2022 May;165(2):215-222. doi: 10.1016/j.ygyno.2022.03.003. Epub 2022 Mar 18.
- Habo YK, Habo NK, Elsayed AAR, Basson MD. Risk factors for postoperative complications following hysterectomy in endometrial cancer patients: A systematic review. J Gynecol Obstet Hum Reprod. 2025 Sep;54(7):102964. doi: 10.1016/j.jogoh.2025.102964. Epub 2025 Apr 30.
- Gallos ID, Yap J, Rajkhowa M, Luesley DM, Coomarasamy A, Gupta JK. Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis. Am J Obstet Gynecol. 2012 Oct;207(4):266.e1-12. doi: 10.1016/j.ajog.2012.08.011. Epub 2012 Aug 10.
- Aune D, Navarro Rosenblatt DA, Chan DS, Vingeliene S, Abar L, Vieira AR, Greenwood DC, Bandera EV, Norat T. Anthropometric factors and endometrial cancer risk: a systematic review and dose-response meta-analysis of prospective studies. Ann Oncol. 2015 Aug;26(8):1635-48. doi: 10.1093/annonc/mdv142. Epub 2015 Mar 19.
- Concin N, Matias-Guiu X, Cibula D, Colombo N, Creutzberg CL, Ledermann J, Mirza MR, Vergote I, Abu-Rustum NR, Bosse T, Chargari C, Espenel S, Fagotti A, Fotopoulou C, Gatius S, Gonzalez-Martin A, Lax S, Levy B, Lorusso D, Macchia G, Marth C, Morice P, Oaknin A, Raspollini MR, Schwameis R, Sehouli J, Sturdza A, Taylor A, Westermann A, Wimberger P, Planchamp F, Nout RA. ESGO-ESTRO-ESP guidelines for the management of patients with endometrial carcinoma: update 2025. Lancet Oncol. 2025 Aug;26(8):e423-e435. doi: 10.1016/S1470-2045(25)00167-6.
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キーワード
追加の関連 MeSH 用語
- 泌尿生殖器疾患
- 生殖器疾患
- 栄養障害
- 泌尿生殖器腫瘍
- 部位別新生物
- 女性の泌尿生殖器疾患
- 女性の泌尿生殖器疾患と妊娠合併症
- 過栄養
- 体重
- 子宮の病気
- 生殖器疾患、女性
- 性器腫瘍、女性
- 子宮腫瘍
- 病理学的状態、徴候および症状
- 栄養および代謝疾患
- 徴候と症状
- 新生物
- 太りすぎ
- 肥満
- 子宮内膜腫瘍
- 子宮内膜増殖症
- 薬物の生理学的影響
- ホルモン
- ホルモン、ホルモン代替品、ホルモン拮抗薬
- ヘルスケアの質、アクセス、評価
- 運動活動
- 動き
- 筋骨格生理学的現象
- 筋骨格および神経生理学的現象
- 調査手法
- 疫学的方法
- 治療
- 診断技術と手順
- 診断
- 外科的処置、手術
- 薬物療法
- 低侵襲外科的処置
- 薬理学的行動
- 化学作用と用途
- データ収集
- ヘルスケア評価メカニズム
- ヘルスケアの質
- 公衆衛生
- 環境と公衆衛生
- 理学療法のモダリティ
- 多環式化合物
- 妊娠
- 妊娠
- ステロイド
- 融合リング化合物
- 患者ケア
- 運動療法
- リハビリテーション
- アフターケア
- 患者ケアの継続性
- 診断技術、外科的
- 内視鏡検査
- 化学技術、分析
- スペクトル分析
- 疫学的測定
- 妊娠
- 妊娠
- 体調、人間
- 泌尿生殖器外科手術
- エクササイズ
- 婦人科の外科的処置
- 産科外科手術
- メドロキシプロゲステロン
- ヒドロキシプロゲステロン
- プロゲステロン
- メストロール
- 診断技術、産婦人科
- ホルモン補充療法
- 酢酸メゲストロール
- 酢酸メドロキシプロゲステロン
- プロゲスチン
- 磁気共鳴分光法
- セマグルチド
- レジスタンストレーニング
- 栄養評価
- 子宮摘出術
- 子宮鏡検査
- エストロゲン補充療法
その他の研究ID番号
- SHAPE-ENDO
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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