Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group

Abstract

ObjectiveTo evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia.MethodsBetween January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients were divided into two groups: the hyperplasia-benign group (261 cases) and the hyperplasia-malignant group (125 cases). Several clinical parameters including age, menopausal status, history of abnormal uterine bleeding, obstetrical history, medical history of diabetes and hypertension, BMI, and preoperative pathologic results were investigated.ResultsAge ≥53 (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.26 to 4.57), menopausal status (OR, 2.07; 95% CI, 1.14 to 3.76), diabetes history (OR, 7.33; 95% CI, 2.79 to 19.26), abnormal uterine bleeding (OR, 3.99; 95% CI, 1.22 to 13.02), atypical endometrial hyperplasia (OR, 7.38; 95% CI, 4.03 to 13.49), and body mass index ≥27 (OR, 3.24; 95% CI, 1.76 to 5.97) were independent risk factors for prediction of endometrial hyperplasia coexisting with endometrial carcinoma. The diagnostic efficacy of atypical endometrial hyperplasia to predict the endometrial hyperplasia coexisting with endometrial carcinoma was better than or similar to those of other independent factors and combinations of these factors.ConclusionCoexisting malignancy should be considered when examining endometrial hyperplasia patients with the related risk factors, especially atypical endometrial hyperplasia.

Endometrial hyperplasia and the risk of coexistent cancer: WHO versus EIN criteria

“…Eighteen studies with a total of 2527 EHs were included in the systematic review . Fourteen studies used the WHO criteria, two used the EIN criteria, and two used both systems.…”

“…6,10 Several authors have assessed the prognostic value of one or both classification systems by considering the rate of coexistent cancer on hysterectomy specimens after a preoperative diagnosis of EH. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] This allows data from different studies to be compared, eliminating the confounding due to the varying durations of follow-up.…”

Prevalence of Co-existing Endometrial Carcinoma in Patients with Preoperative Diagnosis of Endometrial Hyperplasia

“…Progression risk of endometrial hyperplasia to endometrial carcinoma depends on presence of cytologic atypia and its severity [4]. Hysterectomy specimen of patients diagnosed with endometrial hyperplasia especially complex atypical hyperplasia by preoperative endometrial biopsy the probability of being accompanied with endometrial cancer ranged from 15-54% [2,3,[5][6][7][8][9]. In our study, endometrial hyperplasia diagnosed patients by preoperative endometrial biopsy result and diagnosed with endometrial cancer by histopathological examination results was found to be 10.79% which is proportionaly lower than those reported in litertures.…”

MicroRNA-381 inhibits cell proliferation and invasion in endometrial carcinoma by targeting the IGF-1R

“…Although Asian women have a lower risk of EC than those residing in the US and other western countries, the morbidity of EC in China has substantially increased (2). Several risk factors, including hypertension, obesity, diabetes, postmenopausal status, infertility, family history of EC and long-term use of oestrogen, contribute to EC formation and progression (3,4). EC patients at the early stage generally have a good prognosis with a 5-year survival rate of up to 96% (5).…”