Cancer Incidence in Patients with Atypical Endometrial Hyperplasia Managed by Primary Hysterectomy or Fertility-sparing Treatment

Anticancer Res. 2015 Dec;35(12):6799-804.

Abstract

Aim: To compare the risk of developing endometrial carcinoma (EC) in young women with atypical endometrial hyperplasia (AEH) undergoing fertility-sparing management compared to women treated by primary hysterectomy.

Patients and methods: In this multicentric retrospective study, 111 patients with a diagnosis of AEH by endometrial biopsy were included. EC incidence was compared in two groups: 32 patients treated with fertility-sparing management and 79 older patients treated with primary hysterectomy.

Results: The rates of EC diagnosed by pathology of hysterectomy specimens were comparable between the groups. The probability of developing EC at 12, 24 and 36 months were 14%, 21% and 26%, respectively, in patients managed conservatively, and 29%, 37% and 37%, respectively, in patients treated with primary hysterectomy.

Conclusion: Fertility-sparing management of AEH does not increase the risk of diagnosing EC from the hysterectomy specimen.

Keywords: Fertility-sparing management; atypical endometrial hyperplasia; endometrial cancer; progression risk.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Disease Progression
  • Endometrial Hyperplasia / diagnosis
  • Endometrial Hyperplasia / therapy*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / prevention & control*
  • Female
  • Fertility Preservation / methods*
  • Humans
  • Hysterectomy / methods*
  • Incidence
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Young Adult