title: Management and clinical outcomes of endometrial hyperplasia during a 13-year period in Songklanagarind Hospital.
abstract: BACKGROUND
  Endometrial hyperplasia has long been considered a precursor of endometrial cancer but there is no consensus regarding its management.
  
  
  OBJECTIVE
  To identify management practices and evaluate outcomes of treatments for women diagnosed with endometrial hyperplasia (EH).
  
  
  METHODS
  The medical records of endometrial hyperplasia at Songklanagarind Hospital between January 2000 and December 2012 were retrospectively reviewed.
  
  
  RESULTS
  Two hundred ninety seven patients were diagnosed with endometrial hyperplasia during the study period. Four patients who did not come for treatment and could not be contacted were excluded Therefore, 293 patients were included in the study. Simple hyperplasia (SH) was the most common diagnosis accounting for 79.2% of all cases, followed by complex hyperplasia (CH) 13.0%, complex atypical hyperplasia (CAH) 5.8%, and simple atypical hyperplasia (SAH) 2.0%. Seventy-eight percent (18/23) of the patients with atypical endometrial hyperplasia were treated by hysterectomy compared with 9.6% (26/270) of patients without atypia. Of the patients diagnosed with atypical EH, 30.4% (7/23) were associated with endometrial carcinoma. Overall, 6% (12/201) of the women who had initial non-hysterectomy management and had additional tissue taken to assess response, had persistent disease, and 1% (2/201) had progressive disease. Eleven patients (5.9%), who had an initial complete regression during the non-hysterectomy management, experienced a recurrence to EH and 2.1% (4/187) were found to have recurrence to endometrial cancer
  
  
  CONCLUSIONS
  The majority of patients with atypical hyperplasia were managed by initial hysterectomy. The high risk of concomitant endometrial cancer supports this choice of treatment. In the non-atypical EH, the initial non-hysterectomy management was common but EH recurrence and progression to endometrial cancer after the initial regression occurs often. Therefore, long-term follow-up should be advised.
authors.forename: Nathapol
authors.initials: N
authors.lastname: Sirimusika
authors.forename: Krantarat
authors.initials: K
authors.lastname: Peeyananjarassri
authors.forename: Yuthasak
authors.initials: Y
authors.lastname: Suphasynth
authors.forename: Virach
authors.initials: V
authors.lastname: Wootipoom
authors.forename: Kanet
authors.initials: K
authors.lastname: Kanjanapradit
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004714:Endometrial Hyperplasia / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D016889:Endometrial Neoplasms / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand; D016896:Treatment Outcome