Natural history of endometrial hyperplasia

Tabata, Tsutomu; Yamawaki, Takaharu; Yabana, Tadashi; Ida, M.; Nishimura, Kazuaki; Nosé, Yukihiko

doi:10.1007/s004040000151

Cited by 28 publications

(18 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the experience of women diagnosed with SH or CH in our study is likely representative of the general population of women with nonatypical EH. Our study design represents an improvement over previous studies that lacked control groups (Kurman et al, 1985;Lindahl and Willen, 1994;Terakawa et al, 1997;Tabata et al, 2001;Horn et al, 2004;Baak et al, 2005), included few women with EH who developed carcinoma (Kurman et al, 1985;Feldman et al, 1994;Lindahl and Willen, 1994;Horn et al, 2004;Baak et al, 2005) or relied on short follow-up (Terakawa et al, 1997;Tabata et al, 2001). Previous studies expressed risk as crude percentages -e.g., 20% of patients with non-atypical AH (Ferenczy and Gelfand, 1989) or 29% of patients with AH (Kurman et al, 1985) progress to cancerrather than population-based rate ratios.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 20 200 women in the United States who undergo hysterectomy receive a primary hospital discharge diagnosis of EH each year (Keshavarz et al, 2002), but progression risks for EH have not been accurately characterised in rigorous populationbased studies (Silverberg, 2000). Current management of EH relies on largely historical data from studies that lacked adequate control groups (Kurman et al, 1985;Feldman et al, 1995;Terakawa et al, 1997;Tabata et al, 2001;Horn et al, 2004;Baak et al, 2005) and were limited by sample size (Feldman et al, 1995;Tabata et al, 2001), short follow-up (Feldman et al, 1995;Terakawa et al, 1997;Tabata et al, 2001), suboptimal statistical methods (Kurman et al, 1985;Pettersson et al, 1985;Feldman et al, 1995;Terakawa et al, 1997;Tabata et al, 2001;Horn et al, 2004), and minimal clinical and treatment information (Kurman et al, 1985;Pettersson et al, 1985;Terakawa et al, 1997;Tabata et al, 2001;Horn et al, 2004). Endometrial hyperplasia diagnoses can misclassify disease severity because of biopsy sampling errors (Zaino, 2000;Trimble et al, 2006;Zaino et al, 2006) or the community pathologists' reported tendency to overestimate lesion severity (Silverberg, 2000).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

et al. 2007

View full text Add to dashboard Cite

Classifying endometrial hyperplasia (EH) according to the severity of glandular crowding (simple hyperplasia (SH) vs complex hyperplasia (CH)) and nuclear atypia (simple atypical hyperplasia (SAH) vs complex atypical hyperplasia (CAH)) should predict subsequent endometrial carcinoma risk, but data on progression are lacking. Our nested case -control study of EH progression included 138 cases, who were diagnosed with EH and then with carcinoma (1970 -2003) at least 1 year (median, 6.5 years) later, and 241 controls, who were individually matched on age, date, and follow-up duration and counter-matched on EH classification. After centralised pathology panel and medical record review, we generated rate ratios (RRs) and 95% confidence intervals (CIs), adjusted for treatment and repeat biopsies. With disordered proliferative endometrium (DPEM) as the referent, AH significantly increased carcinoma risk (RR ¼ 14, 95% CI, 5 -38). Risk was highest 1 -5 years after AH (RR ¼ 48, 95% CI, 8 -294), but remained elevated 5 or more years after AH (RR ¼ 3.5, 95% CI, 1.0 -9.6). Progression risks for SH (RR ¼ 2.0, 95% CI, 0.9 -4.5) and CH (RR ¼ 2.8, 95% CI, 1.0 -7.9) were substantially lower and only slightly higher than the progression risk for DPEM. The higher progression risks for AH could foster management guidelines based on markedly different progression risks for atypical vs non-atypical EH.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

et al. 2007

View full text Add to dashboard Cite

show abstract

“…The rate of progression to endometrial carcinoma has been estimated to be 0-3% in patients without atypia, 0-8% in patients with simple atypical hyperplasia, and 9-29% in patients with complex atypical endometrial hyperplasia (CAEH) (Kurman et al, 1985;Tabata et al, 2001). The risk of concomitant endometrial carcinoma has been reported to be 20-59% in CAEH (Lambert et al, 1994;Kimura et al, 2003;Valenzuela et al, 2003;Antonsen et al, 2012;Morotti et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of Frozen Sections for Intraoperative Diagnosis of Complex Atypical Endometrial Hyperplasia

Turan¹,

Karadağ²,

Karabük³

et al. 2012

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

“…In contrast, Tabata et al observed spontaneous regression of endometrial hyperplasia in all risk groups, and the overall regression rates were 79% for SH, 100% for AH, 94% for CH, and 55% for CAH; regression occurred mostly within the first year (Tabata et al, 2001). Clearly, results were improved with a follow-up of longer duration.…”

Section: Discussionmentioning

confidence: 83%

“…The SH regression rate has been reported to be 74-80%, with a 1% progression rate ( Tabata et al, 2001;Montgomery et al, 2004). In a recent study, complete resolution was found in 72% of 60 cases after 3 months of progestin therapy, with no progression (Tasci et al, 2014).…”

Section: Discussionmentioning

confidence: 96%

Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia

Mesci-Haftaci

Ankaralı²,

Yavuzcan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia.

show abstract

Natural history of endometrial hyperplasia

Cited by 28 publications

References 3 publications

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan

Accuracy of Frozen Sections for Intraoperative Diagnosis of Complex Atypical Endometrial Hyperplasia

Endometrial Curettage in Abnormal Uterine Bleeding and Efficacy of Progestins for Control in Cases of Hyperplasia

Contact Info

Product

Resources

About