Factors predictive of endometrial carcinoma in patients with atypical endometrial hyperplasia on preoperative histology

Abstract

Aim: To identify predictive factors of endometrial cancer in patients with atypical endometrial hyperplasia (AEH). Patients and Methods: This was a retrospective cohort study of 79 patients diagnosed with AEH. Clinicopathological characteristics of patients and final histology on hysterectomy were reviewed and univariate and multivariate analyses were performed. Results: Nineteen cases of endometrial cancer (24%) were diagnosed at final histology. Most patients had IA (n=15, 79%) grade 1 (n=15, 79%) cancer, but two had FIGO stage IIIC (10.5%). The predictive factors of endometrial cancer on final histology in univariate analysis were: hysteroscopic sampling, older age, post-menopausal status, suspicion of cancer on hysteroscopy and suspicion of cancer at histology. In multivariable analysis, the only predictive factors of endometrial cancer were older age and the suspicion of cancer on hysteroscopy. Conclusion: In patients with AEH on biopsy, our results showed that hysteroscopy could be performed both to assess macroscopic features of malignancy and to orient biopsy.