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- Title
Relapse risk of endometrial hyperplasia after treatment with the levonorgestrel-impregnated intrauterine system or oral progestogens.
- Authors
Ørbo, A; Arnes, M; Vereide, AB; Straume, B; Ørbo, A; Vereide, A B
- Abstract
<bold>Objective: </bold>To investigate relapse rates after the successful treatment of patients with non-atypical endometrial hyperplasia who were randomised to either a levonorgestrel-impregnated intrauterine system (LNG-IUS; Mirena(®) ) or two regimens of oral medroxyprogesterone acetate (MPA) after primary histological response.<bold>Design: </bold>A multicentre randomised trial.<bold>Setting: </bold>Ten different outpatient clinics localised in hospitals and seven gynaecological private practices in Norway.<bold>Population: </bold>One hundred and fifty-three women aged 30-70 years with low- or medium-risk endometrial hyperplasia met the inclusion criteria, and 153 completed the therapy.<bold>Methods: </bold>Patients were randomly assigned to one of the following three treatment arms: LNG-IUS; 10 mg of oral MPA administered for 10 days per cycle for 6 months; or 10 mg of oral MPA administered daily for 6 months. The women were followed for 24 months after ending therapy.<bold>Main Outcome Measures: </bold>Histological relapse of endometrial hyperplasia.<bold>Results: </bold>Histological relapse was observed in 55/135 (41%) women who had an initial complete treatment response. The relapse rates were similar in the three therapy groups (P = 0.66). In the multivariable analyses relapse was dependent on menopausal status (P = 0.0005) and estrogen level (P = 0.0007).<bold>Conclusions: </bold>The risk of histological relapse of non-atypical endometrial hyperplasia is high within 24 months of ceasing therapy with either the LNG-IUS or oral MPA. Continued endometrial surveillance and prolonging progestogen therapy should be considered.<bold>Tweetable Abstract: </bold>Relapse of endometrial hyperplasia after successful treatment is independent of therapy regime.
- Subjects
ENDOMETRIAL hyperplasia; PROGESTATIONAL hormones; LABOR (Obstetrics); DELIVERY (Obstetrics); SYMPTOMS; ANTINEOPLASTIC agents; COMPARATIVE studies; CONTRACEPTIVE drugs; INTRAUTERINE contraceptives; RESEARCH methodology; MEDICAL cooperation; ORAL drug administration; MEDROXYPROGESTERONE; RESEARCH; UTERINE diseases; DISEASE relapse; EVALUATION research; RANDOMIZED controlled trials; LEVONORGESTREL; THERAPEUTICS
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2016, Vol 123, Issue 9, p1512
- ISSN
1470-0328
- Publication type
Academic Journal
- DOI
10.1111/1471-0528.13763