The clinical and reproductive outcomes of endometrial intraepithelial neoplasia: experience of 117 cases

Year 2023, Volume: 23 Issue: 3, 52 - 57, 28.12.2023

Burak Giray , Emin Erhan Dönmez , Fatih Kaya , Hamdullah Sözen , Yavuz Salihoglu , Samet Topuz , Doğan Vatansever

https://doi.org/10.59215/trsgo.1292019

Abstract

Aim: Hysterectomy is the suggested treatment for endometrial intraepithelial neoplasia since there is a high risk of coexisting endometrial adenocarcinoma in this subset of patients. However, fertility sparing treatment modalities can also be an option for patients with endometrial intraepithelial neoplasia who desire to preserve their fertility. In this study our aim was to evaluate the clinical and reproductive outcomes of endometrial intraepithelial neoplasia.

Materials and methods: We retrospectively analyzed the records of 117 patients with atypical hyperplasia (AH)/endometrial intraepithelial neoplasia (EIN) in a tertiary gynecological cancer center. The median follow-up time was 54 (7-96) months.

Results: One hundred and one women underwent hysterectomy. The rate of coexistent endometrial carcinoma in women with AH/EIN was 33.7%. Sixteen women were treated conservatively. The complete response rate was 75% in patients after a treatment period of 12 months. Four of the patients in the infertile group had a successful live birth, 2 spontaneously and 2 with in vitro fertilization. Two patients in the fertile group had a successful live birth, 2 spontaneously.

Conclusion: Fertility sparing management is a feasible option for patients with atypical hyperplasia. However, it is crucial that there are high rates of coexisting endometrial cancer in these patients. Patients with AH/EIN should be followed up carefully for endometrial adenocarcinoma with regular endometrial samplings.

Keywords

Endometrial Hyperplasia, Endometrial Intraepithelial Neoplasia, Endometrial Cancer, Fertility-Sparing Treatment

Endometrial i̇ntraepitelyal neoplazinin klinik ve repordüktif sonuçları: 117 vakanın deneyimi

Abstract

Amaç: Histerektomi, endometrial intraepitelyal neoplazi için önerilen tedavidir, çünkü bu hasta alt grubunda endometrial adenokarsinom ile birliktelik riski yüksektir. Bununla birlikte, fertilitesini korumak isteyen endometrial intraepitelyal neoplazili hastalar için fertilite koruyucu tedavi modaliteleri de bir seçenek olabilir. Bu çalışmada amacımız endometriyal intraepitelyal neoplazinin klinik ve reprodüktif sonuçlarını değerlendirmektir.

Gereç ve yöntem: Üçüncül bir jinekolojik kanser merkezinde atipik hiperplazi (AH)/endometrial intraepitelyal neoplazi (EIN) olan 117 hastanın kayıtlarını retrospektif olarak incelendi. Median takip süresi 54 (7-96) aydır.

Bulgular: Yüz bir kadına histerektomi yapıldı. AH/EIN’li kadınlarda eşlik eden endometriyal karsinom oranı %33,7 idi. On altı kadın konservatif olarak tedavi edildi. 12 aylık tedavi süresinden sonra hastalarda tam yanıt oranı %75 idi. İnfertil gruptaki hastaların 2’si spontan, 2’si tüp bebek ile olmak üzere 4’ü başarılı bir canlı doğum gerçekleştirdi. Fertil grupdaki 2 hasta spontan olarak başarılı 2 canlı doğum gerçekleştirdi.

Sonuç: Atipik hiperplazisi olan hastalar için fertilite koruyucu tedavi uygulanabilir bir seçenektir. Bununla birlikte, bu hastalarda yüksek oranda birliktelik gösteren endometrial kanser oranları çok önemlidir. AH/EIN’li hastalar, düzenli endometrial örneklemeler ile endometriyal adenokarsinom açısından dikkatle izlenmelidir.

Keywords

Endometriyal Hiperplazi, Endometriyal İntraepitelyal Neoplazi, Endometriyal Kanser, Fertilite Koruyucu Tedavi

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