Management of Endometrial Hyperplasia With a Levonorgestrel-Releasing Intrauterine System: A Korean Gynecologic-Oncology Group Study
- Abstract
- OBJECTIVE: The aim of the study was to evaluate the efficacy of the levonorgestrel intrauterine system (LNG-IUS) for treatment of endometrial hyperplasia (EH). METHODS: A prospective multicenter study was conducted from November 2010 to March 2014. Patients with histologically confirmed EH were treated with LNG-IUS. At 3, 6, and 9 months after LNG-IUS insertion, follow-up endometrial aspiration biopsies with the LNG-IUS in the uterus were undertaken. At the 12th month of follow-up, endometrial tissues were obtained via 2 methods: endometrial aspiration biopsy with the LNG-IUS in the uterus, followed by dilatation and curettage (D&C) after LNG-IUS removal. The primary outcome was the regression rate at 12 months after LNG-IUS insertion, and the secondary outcome was the consistency of the results between the endometrial aspiration biopsy and the D&C. RESULTS: The study population comprised 75 patients, including 37 with simple hyperplasia without atypia; 3 with atypical simple hyperplasia; 23 with complex hyperplasia without atypia, and 12 with atypical complex hyperplasia. Of these patients treated with the LNG-IUS, 38 (50.7%) were followed up at 12 months after LNG-IUS insertion. The complete regression rate at 12 months was 94.7% (36/38): 100% (6/6) of patients with atypical EH and 93.7% (30/32) with EH without atypia. In all of the cases (100%, 36/36), patients achieved complete regression within 3 months of LNG-IUS insertion. A comparison of the pathologic results from endometrial aspiration biopsy and D&C was carried out for 15 patients. In the histologic results by endometrial aspiration biopsy, 14 patients were diagnosed as normal endometrium" and 1 as "insufficient tissue for pathologic evaluation." Among the 14 cases of normal endometrium by endometrial aspiration biopsy, 1 was diagnosed as "residual EH" by D&C, and the 1 case with insufficient tissue was diagnosed as normal endometrium by D&C. CONCLUSIONS: Levonorgestrel intrauterine system is an effective and favorable method for treatment of EH."
- All Author(s)
- M. K. Kim
; S. J. Seong
; J. W. Kim
; S. Jeon
; H. S. Choi
; I. H. Lee
; J. H. Lee
; W. Ju
; E. S. Song
; H. Park
; H. S. Ryu
; C. Lee
; S. B. Kang
- Issued Date
- 2016
- Type
- Article
- Keyword
- Adult; Biopsy, Fine-Needle; Contraceptive Agents, Female/*administration & dosage; Disease Management; Endometrial Hyperplasia/*drug therapy/pathology; Female; Follow-Up Studies; Humans; Intrauterine Devices, Medicated/*statistics & numerical data; Levonorgestrel/*administration & dosage; Middle Aged; Neoplasm Staging; Prognosis; Prospective Studies; Young Adult
- Publisher
- International Gynecological Cancer Society
- ISSN
- 1048-891x
- Citation Title
- International Journal of Gynecologic Cancer
- Citation Volume
- 26
- Citation Number
- 4
- Citation Start Page
- 711
- Citation End Page
- 715
- Language(ISO)
- eng
- DOI
- 10.1097/igc.0000000000000669
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3289
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