Short-term treatment results of endometrial hyperplasia without atypia
Abstract
Objectives: Endometrial hyperplasia is a pathology that often represents with abnormal uterine bleeding and develops under the influence of unopposed estrogen. In this study, the response to cyclic medroxyprogesterone acetate (MPA) treatment in endometrial hyperplasia without atypia, which is known to have a good response to progestagen agents, was retrospectively evaluated.
Methods: Control endometrial biopsy results of 111 patients who were initiated cyclic MPA treatment due to endometrial biopsy results of endometrial hyperplasia without atypia were evaluated after 3 months of treatment. Endometrial hyperplasia free biopsy results after treatment were accepted as a successful treatment in those patient.
Results: Control biopsies revealed proliferative endometrium in 37 (33.3%) patients, secretory endometrium in 34 (30.6%) patients, inactive endometrium in 9 (8.1%) patients, endometritis in 4 (3.6%) patients, endometrial hyperplasia without atypia in 26 (23,4%) patients, and endometrial hyperplasia with atypia in 1 (0.9%) patient. Our response rate to treatment was 75.7% (84/111) and the persistence was found to be 23.4% (26/111). In patients with a positive response to treatment (n = 84), the mean age was 45.15 ± 5.19 years and in patients with no response to treatment (n = 27) the mean age was 45.56 ± 6.41 years, and there is no difference between the two groups in terms of average age.
Conclusions: Although the use of cyclic MPA in the treatment of endometrial hyperplasia without atypia is an effective treatment method, we believe that better results will be achieved in the use of more than 3 months duration.
Keywords
References
- 1. Kurman RJ, Carcangiu M, Herrington C, Young R World Health Organisation Classification of Tumors of Female Reproductive Organs, 4th edn. Lyon France: International Agency for Research on Cancer (IARC) Press, 2014.
- 2. Trimble CL, Method M, Leitao M, Lu K, Ioffe O, Hampton M, et al; Society of Gynecologic Oncology Clinical Practice Committee. Management of endometrial precancers. Obstet Gynecol 2012;120:1160-75.
- 3. National Collaborating Centre for Women's and Children's Health (UK). Heavy Menstrual Bleeding. London: RCOG Press; 2007.
- 4. Singh S, Best C, Dunn S, Leyland N, Wolfman WL. No. 292-Abnormal uterine bleeding in pre-menopausal women. J Obstet Gynaecol Can 2018;40:e391-e415.
- 5. Sanderson PA, Critchley HO, Williams AR, Arends MJ, Saunders PT. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update 2017;23:232-54.
- 6. Mutter GL, Zaino RJ, Baak JPA, Bentley RC, Robboy SJ. Benign endometrial hyperplasia sequence and endometrial intraepithelial neoplasia. Int J Gynecol Pathol 2007;26:103-14.
- 7. Travaglino A, Raffone A, Saccone G, Mascolo M, Pignatiello S, Mollo A, et al. PTEN immunohistochemistry in endometrial hyperplasia: which are the optimal criteria for the diagnosis of precancer?. APMIS 2019;127:161-9.
- 8. Gallos ID, Alazzam M, Clark TJ, Faraj R, Rosenthal AN, Smith PP, et al. Management of endometrial hyperplasia. Green-top guideline No 67. London: Royal College of Obstetricians and Gynaecologists; 2016. Available at:https://www.rcog.org.uk/globalassets/documents/guidelines/green-top guidelines/gtg_67_endometrial_hyperplasia.pdf. Accessed on April 15, 2019.
Details
Primary Language
English
Subjects
Obstetrics and Gynaecology
Journal Section
Research Article
Authors
Zeliha Atak
*
0000-0002-4876-0573
Türkiye
Ayşe Erdoğan
This is me
0000-0002-2169-8423
Türkiye
Gökhan Ocakoğlu
0000-0002-1114-6051
Türkiye
Publication Date
July 4, 2022
Submission Date
July 8, 2021
Acceptance Date
January 10, 2022
Published in Issue
Year 1970 Volume: 8 Number: 4