Enis Ozkaya1, Vakkas Korkmaz2, Yeşim Ozkaya2, Alptekin Tosun3, Tuncay Küçükozkan2, Hüsne Bostan4. 1. Department of Obstetrics and Gynecology, School of Medicine, Giresun University, Giresun, Turkey. 2. Department of Obstetrics & Gynecology, Dr.Sami Ulus Maternity and Children's Health Teaching and Research Hospital, Ankara, Turkey. 3. Department of Radiology, School of Medicine, Giresun University, Giresun, Turkey. 4. Department of Obstetrics and Gynecology, Giresun Maternity Hospital, Giresun Turkey.
Abstract
OBJECTIVE: We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia. MATERIAL AND METHODS: We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success. RESULTS: Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03). CONCLUSION: Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia.
OBJECTIVE: We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia. MATERIAL AND METHODS: We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success. RESULTS: Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03). CONCLUSION: Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia.
Authors: Betsy A McCormick; Rochelle D Wilburn; Michael A Thomas; Daniel B Williams; Rose Maxwell; Mira Aubuchon Journal: Fertil Steril Date: 2011-05-07 Impact factor: 7.329
Authors: T Kalampokas; O Gregoriou; G Odysseas; C Grigoriadis; L Grigoriadis; C Iavazzo; A Zervakis; C Sofoudis; E Kalampokas; D Botsis Journal: Eur J Gynaecol Oncol Date: 2012 Impact factor: 0.196