title: Complex atypical hyperplasia of the uterus: characteristics and prediction of underlying carcinoma risk.
abstract: OBJECTIVE
  The objective of the study was to identify additional factors that may improve the ability to predict underlying carcinoma risk in patients with complex atypical hyperplasia (CAH) of the uterus.
  
  
  METHODS
  All subjects diagnosed with CAH of the uterus on endometrial sampling from March 1994 to May 2008 were identified. CAH was classified as CAH suspicious, CAH polypoid, CAH focal, or CAH not otherwise specified (NOS). Subjects were then exclusively assigned to 1 of 3 categories: CAH suspicious, CAH NOS, or CAH focal and/or polypoid.
  
  
  RESULTS
  We identified 197 cases of CAH diagnosed on preoperative endometrial sampling. Carcinoma was subsequently diagnosed in the hysterectomy specimen in 67 subjects (34%). The risk of underlying carcinoma if assigning subjects as CAH suspicious, CAH NOS, or CAH polypoid and/or focal was 56%, 36%, and 20%, respectively (P < .001).
  
  
  CONCLUSIONS
  The risk of underlying carcinoma in patients with CAH on preoperative endometrial sampling is associated with the method of sampling and age and can be significantly modified by the nature of pathologic assessment.
authors.affiliation: Division of Gynecology, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Mario M
authors.initials: MM
authors.lastname: Leitao
authors.forename: Guangming
authors.initials: G
authors.lastname: Han
authors.forename: Lisa X
authors.initials: LX
authors.lastname: Lee
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
authors.forename: Carol L
authors.initials: CL
authors.lastname: Brown
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Chi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Levine
authors.forename: Ginger J
authors.initials: GJ
authors.lastname: Gardner
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Jewell
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
authors.forename: Robert A
authors.initials: RA
authors.lastname: Soslow
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002277:Carcinoma / Q000175:diagnosis* / Q000601:surgery; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000601:surgery; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007044:Hysterectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011230:Precancerous Conditions; D018570:Risk Assessment; D014599:Uterus / Q000473:pathology* / Q000601:surgery