The process of carcinogenesis for endometrial adenocarcinoma could be short: Development of a malignancy after endometrial ablation

Ramey, Jacques W.; Koonings, Paul P.; Given, Fred T.; Acosta, Anı́bal A.

doi:10.1016/s0002-9378(94)70158-x

Cited by 34 publications

(16 citation statements)

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“…EC after endometrial ablation is a rare but possible occurrence, as described in the literature in a number of case reports [13][14][15][16][17][18][19][20][21][22]. The exact rate of EC after endometrial ablation is still unknown, but the most common symptom is recurrent abnormal bleeding and the state of cancer diagnosed is advanced in many of the cases described [14,[16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

“…In all of the cases described in the literature except two [13][14][15][16][17][18][19][20][21][22], the endometrial ablation was performed by rollerball coagulation. In our study, complete endometrial ablation by resecting loop was performed in three of the four cases (one of these three cases had endometrial resection by HRT, Hormone replacement therapy; TH, total hysterectomy; BSO, bilateral salpingo ophorectomy monopolar resecting loop followed by monopolar "rollerball" coagulation of the uterine cavity), while in the remaining one case complete endometrial polyps resection was performed by resecting loop followed by complete curettage of the uterine cavity.…”

Section: Discussionmentioning

confidence: 99%

“…The principle of the technique is to remove the whole thickness of the endometrium and some of the superficial myometrium to ensure complete removal of the endometrial basal glands, using a monopolar or bipolar resecting loop or coagulating electrode ("roller-ball"). However, despite the theoretically complete ablation of the endometrium, cases of endometrial cancer (EC) after endometrial ablation have been described in the literature [13][14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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Endometrial cancer following endometrial resection

et al. 2007

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Endometrial ablation has emerged as a viable alternative to hysterectomy in the treatment of medically intractable dysfunctional uterine bleeding. However, this procedure cannot guarantee complete removal of the entire endometrium. Cases of endometrial cancer after endometrial ablation have been reported in the literature. We reviewed the cases of patients who underwent hysteroscopic endometrial ablation by endometrial resection for abnormal uterine bleeding from 1994 to 2005 at the Department of Obstetrics and Gynecology, Polyclinique, Clermont-Ferrand University. Of the 3769 patients having had hysteroresections, four developed endometrial cancer after complete endometrial ablation (1.06 out of 1000). All four of these patients showed histological evidence of endometrial polyps at endometrial resection, and all of them presented risk factors for endometrial carcinoma, such as obesity and/or arterial hypertension. Endometrial cancer after hysteroscopic endometrial ablation is a rare but possible occurrence, even a long time after the operation. Close monitoring of patients who have undergone endometrial ablation for endometrial polyps and who present risk factors, such as obesity or hypertension, even after apparent total ablation of the endometrium is strongly recommended, independently of the presence of abnormal bleeding that can represent a late symptom of advanced endometrial cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endometrial cancer following endometrial resection

et al. 2007

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“…Istre et al [10] showed that an estrogen therapy alone led to a higher number of hyperplasias and should be avoided. A preoperative exclusion of hyperplasia is important, because the development of endometrial carcinoma can be short [11,12]. After endometrial ablation the diagnostics of the corpus carcinoma can be difficult because the cavity is obliterated [13].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Recurrent Bleeding Disorders during Hormone Replacement Therapy by Transcervical Endometrial Ablation

Römer¹

1999

Gynecol Obstet Invest

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If bleeding disorders, which could not be treated by modification of steroid dosages, occurred during sequential hormone replacement therapy (HRT), most of the patients stopped HRT. In these cases a diagnostic outpatient hysteroscopy with biopsy was carried out. In most of the cases no intrauterine cause for the bleeding disorder was found. In 35 patients we performed an endometrial ablation without intra- or postoperative complications. After this procedure all patients received a combined continuous HRT. In a follow-up of 12 months 34 patients were amenorrheic and satisfied with the treatment. One patient stopped HRT because of suffering from other side effects. Endometrial ablation represents a method of treating patients with bleeding disorders without intrauterine causes with a minimal invasive procedure. A continuous combined HRT is possible after the endometrial ablation in perimenopausal and postmenopausal patients without bleeding disorders. In selected cases endometrial ablation can contribute to the increase of the compliance with HRT.

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“…We agree that hysteroscopy will be more sensitive in detecting endometrial lesions. However, the procedure is not without hazards (Ditton 1992), and it is known that early endometrial malignant lesions could also be missed at hysteroscopy and curettage (Ramey 1994).…”

Section: Authors' Replymentioning

confidence: 99%

Authors' Reply

Britton¹

1995

BJOG

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The process of carcinogenesis for endometrial adenocarcinoma could be short: Development of a malignancy after endometrial ablation

Cited by 34 publications

References 1 publication

Endometrial cancer following endometrial resection

Endometrial cancer following endometrial resection

Treatment of Recurrent Bleeding Disorders during Hormone Replacement Therapy by Transcervical Endometrial Ablation

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