Cancer Incidence in Patients with Atypical Endometrial Hyperplasia Managed by Primary Hysterectomy or Fertility-sparing Treatment

摘要

Aim: To compare the risk of developing endometrial carcinoma (EC) in young women with atypical endometrial hyperplasia (AEH) undergoing fertility-sparing management compared to women treated by primary hysterectomy. Patients and Methods: In this multicentric retrospective study, 111 patients with a diagnosis of AEH by endometrial biopsy were included. EC incidence was compared in two groups: 32 patients treated with fertility-sparing management and 79 older patients treated with primary hysterectomy. Results: The rates of EC diagnosed by pathology of hysterectomy specimens were comparable between the groups. The probability of developing EC at 12, 24 and 36 months were 14%, 21% and 26%, respectively, in patients managed conservatively, and 29%, 37% and 37%, respectively, in patients treated with primary hysterectomy. Conclusion: Fertility-sparing management of AEH does not increase the risk of diagnosing EC from the hysterectomy specimen.