Journal of SAFOMS

Register      Login

VOLUME 6 , ISSUE 1 ( January-June, 2018 ) > List of Articles

RESEARCH ARTICLE

Complex Endometrial Hyperplasia: Prevalence and Risk Factors for coexisting Endometrial Carcinoma

Sheikh Irfan, Munazza Akhtar, Uzma Chishti, Aliya B Aziz, Iffat Ahmad

Keywords : Complex endometrial hyperplasia, Endometrial carcinoma, Risk factors

Citation Information : Irfan S, Akhtar M, Chishti U, Aziz AB, Ahmad I. Complex Endometrial Hyperplasia: Prevalence and Risk Factors for coexisting Endometrial Carcinoma. J South Asian Feder Menopause Soc 2018; 6 (1):62-64.

DOI: 10.5005/jp-journals-10032-1138

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: This study was planned to observe the prevalence of endometrial carcinoma in patients with complex endometrial hyperplasia. It has also assessed the risk factors for concomitant endometrial carcinoma. Materials and methods: Retrospective analysis of 71 patients with complex endometrial hyperplasia surgically treated between 1995 and 2015 in Aga Khan University Hospital, Karachi, Pakistan, was performed. Results: The prevalence rate of concurrent endometrial carcinoma in patients with endometrial hyperplasia was 34%. The rate for concurrent endometrial carcinoma in patients with complex hyperplasia with atypia was 49% as compared with 4.2% in patients without atypia. Cancer risk was significantly related to menopause (p = 0.043) and presence of atypia (p = 0.0005). Multivariate analysis to adjust for confounders revealed that cytological atypia [odds ratio (OR), 17.12; 95% confidence interval (CI), 2.07–141.42], menopause (OR, 2.07; 95% CI, 0.51–7.91), and hypertension (OR, 1.67; 95% CI, 0.51–5.44) were independent risk factors for endometrial hyperplasia coexisting with endometrial carcinoma Conclusion: The optimal management for menopausal women with complex hyperplasia along with atypia should be surgical intervention. We recommend that these women should be managed in centers where expertise and skills of adequate surgical staging are available.


PDF Share
  1. Montgomery BE, Daum GS, Dunton CJ. Endometrial hyperplasia: a review. Obstet Gynecol Surv 2004 May;59(5): 368-378.
  2. Hahn HS, Chun YK, Kwon YI, Kim TJ, Lee KH, Shim JU, Mok JE, Lim KT. Concurrent endometrial carcinoma following hysterectomy for atypical endometrial hyperplasia. Eur J Obstet Gynecol Reprod Biol 2010 May;150(1):80-83.
  3. Clark TJ, Neelakantan D, Gupta JK. The management of endometrial hyperplasia: an evaluation of current practice. Eur J Obstet Gynecol Reprod Biol 2006 Apr;125(2): 259-264.
  4. Chen YL, Cheng WF, Lin MC, Huang CY, Hsieh CY, Chen CA. Concurrent endometrial carcinoma in patients with a curettage diagnosis of endometrial hyperplasia. J Formos Med Assoc 2009 Jun;108(6):502-507.
  5. Merisio C, Berretta R, De Ioris A, Pultrone DC, Rolla M, Giordano G, Tateo S, Melpignano M. Endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia. Eur J Obstet Gynecol Reprod Biol 2005 Sep;122(1):107-111.
  6. Trimble CL, Kauderer J, Zaino R, Silverberg S, Lim PC, Burke JJ 2nd, Alberts D, Curtin J. Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer 2006 Feb;106(4):812-819.
  7. Lacey JV Jr, Sherman ME, Rush BB, Ronnett BM, Ioffe OB, Duggan MA, Glass AG, Richesson DA, Chatterjee N, Langholz B. Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia. J Clin Oncol 2010 Feb;28(5):788-792.
  8. Leitao MM Jr, Kehoe S, Barakat RR, Alektiar K, Rabbitt C, Chi DS, Soslow RA, Abu-Rustum NR. Endometrial sampling diagnosis of FIGO grade 1 endometrial adenocarcinoma with a background of complex atypical hyperplasia and final hysterectomy pathology. Am J Obstet Gynecol 2010 Mar;202(3):278e1-278e6.
  9. Beavis AL, Cheema S, Holschneider CH, Duffy EL, Amneus MW. Almost half of women with endometrial cancer or hyperplasia do not know that obesity affects their cancer risk. Gynecol Oncol Rep 2015 Jul;13:71-75.
  10. Matsuo K, Ramzan AA, Gualtieri MR, Mhawech-Fauceglia P, Machida H, Moeini A, Dancz CE, Ueda Y, Roman LD. Prediction of concurrent endometrial carcinoma in women with endometrial hyperplasia. Gynecol Oncol 2015 Nov;139(2): 261-267.
  11. Rakha E, Wong SC, Soomro I, Chaudry Z, Sharma A, Deen S, Chan S, Abu J, Nunns D, Williamson K, et al. Clinical outcome of atypical endometrial hyperplasia diagnosed on an endometrial biopsy: institutional experience and review of literature. Am J Surg Pathol 2012 Nov;36(11):1683-1690.
  12. Janicek MF, Rosenshein NB. Invasive endometrial cancer in uteri resected for atypical endometrial hyperplasia. Gynecol Oncol 1994 Mar;52(3):373-378.
  13. Bilgin T, Ozuysal S, Ozan H, Atakan T. Coexisting endometrial cancer in patients with a preoperative diagnosis of atypical endometrial hyperplasia. J Obstet Gynaecol Res 2004 Jun;30(3):205-209.
  14. Matias-Guiu X, Catasus L, Bussaglia E, Lagarda H, Garcia A, Pons C, Muñoz J, Argüelles R, Machin P, Prat J. Molecular pathology of endometrial hyperplasia and carcinoma. Hum Pathol 2001 Jun;32(6):569-577.
  15. Farquhar CM, Lethaby A, Sowter M, Verry J, Baranyai J. An evaluation of risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding. Am J Obstet Gynecol 1999 Sep;181(3):525-529.
  16. Salman MC, Usubutun A, Boynukalin K, Yuce K. Comparison of WHO and endometrial intraepithelial neoplasia classifications in predicting the presence of coexistent malignancy in endometrial hyperplasia. J Gynecol Oncol 2010 Jun;21(2): 97-101.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.