Resolving the Predictive Ability of Simple Hyperplasia
O Habeeb, DB Seligson, CH Ersahin. Loyola University Medical Center, Maywood, IL; David Geffen School of Medicine at UCLA, Los Angeles, CA
Background: Simple hyperplasia (SH) is an early, preneoplastic lesion of the endometrium. Previous studies have attempted to characterize the rate (Kurman RJ, Kaminski PF, Norris HJ, 1985) and risk (Lacey JV, Jr., Ioffe OB, Ronnett BM, et al., 2008) of progression from SH to endometrial cancer (EC). However, studies like these have examined the progression of SH alone, as it directly relates to EC. In contrast, our study significantly refines the prediction of SH progression by first determining whether a woman's first SH regresses or not.
Design: We performed a metachronous, retrospective data analysis of selected cases from the David Geffen School of Medicine at UCLA (1982-2002) and Loyola University Medical Center (1988-2008). Included in the analysis were patients with at least three endometrial samplings during their follow-up at each institution, along with those who fulfilled established progression criteria (Lacey JV, Jr., et al., 2008). 'Benign' endometrium consisted of non-hyperplastic, non-neoplastic samples.
Results: Women within the UCLA group, whose first SH reverted to benign endometrium on the subsequent biopsy, were at lower risk of developing endometrial cancer (Log-rank P = .0342, N = 26). In addition, when the Loyola group was combined with the UCLA group, the significance of the relationship was maintained (Log-rank P = .0358, N = 44; see Figure 1).
Conclusions: Our predictive model suggests that women whose first SH regresses to benign endometrium are at lower risk of developing cancer over time. The preservation of the significant trend in the combined group suggests that the results are more likely to be robust and merit further investigation. Potentially confounding clinical factors are addressed and discussed.
Category: Gynecologic & Obstetrics
Wednesday, March 24, 2010 9:30 AM
Poster Session V # 119, Wednesday Morning