Prevalence of occult endometrial carcinoma in patients with endometrial intraepithelial neoplasia underwent hysterectomy at Siriraj Hospital

Abstract

Contentsage of 45 years at the time of diagnosis. Data were abstracted regarding age, parity, diabetes, hypertension, poly cystic ovaries, body mass index (BMI), tumor histology, grade, stage, and survival. Clinical and pathological characteristic were compared, and statistical analyses were performed using SPSS version 22.0. Results: The mean age at the time of diagnosis was 38.50 years (range, 34.50-41.25) and mean BMI (kg/m 2 ) was 30.55 (range, 27.23-38.45). 50% patients were obese (BMI >30 kg/m 2 ) and 40% were overweight (BMI 25-30 kg/m 2 ). Only 5 out 10 women had nulliparity, however, 70% women had history of polycystic ovaries, confirmed with ultrasound or on histopathological specimen. Family history was also found to be strongly associated with endometrial cancer with 70% prevalence rate. The prevalence of diabetes mellitus, hypertension and hypothyroidism were 20%, 10% and 10% respectively. Seven patients (70%) had well differentiated tumors, 2 (20%) moderately differentiated and 1 (10%) had poorly differentiated tumor. Stage 1A disease was found in 7 (70%) patients, stage 1B in 1 (10%), stage 2 in 1(10%) and stage 3 in 1 (10%) patient. 20 % patients had completed 5-years disease free interval, one patient was expired with recurrence and stage 3 disease, while 1 woman was lost to follow up after surgery. Conclusion:We conclude that the obesity, family history and polycystic ovaries are strongly associated risk factors for endometrial cancer in women aged 45 years or younger. We could not find any significant association with medical disorders such as diabetes and hypertension. Nulliparity seems to have less strong relationship with development of endometrial cancer. Majority of young patients have early-stage disease with well differentiated tumors and favorable histology.