title: Comparison of diagnostic accuracy between endometrial curettage and pipelle aspiration biopsy in patients treated with progestin for endometrial hyperplasia: a Korean Gynecologic Oncology Group Study (KGOG 2019).
abstract: A prospective multicenter trial has been started in Korea to evaluate the diagnostic accuracy of endometrial aspiration biopsy compared with dilatation and curettage in patients treated with progestin for endometrial hyperplasia. For conservative treatment of endometrial hyperplasia, orally administered progestins are most commonly used method with various treatment regimens and more recently, the levonorgestrel-releasing intrauterine system also has been used successfully to treat endometrial hyperplasia. However, there is no report about the accuracy of endometrial sampling during hormonal treatment for follow-up evaluation of endometrial hyperplasia. Patients with histologically confirmed endometrial hyperplasia are offered hormonal treatment with any one of the following three options: oral medroxyprogesterone acetate 10 mg/day for 14 days per cycle, continuous oral medroxyprogesterone acetate 10 mg/day or insertion of levonorgestrel-releasing intrauterine system. Histological surveillance is performed at 3 months or 6 months following initial treatment. Endometrial tissues are obtained via endometrial aspiration biopsy using a pipelle and dilatation and curettage. In the case of levonorgestrel-releasing intrauterine system, endometrial aspiration biopsy will be done with levonorgestrel-releasing intrauterine system in uterus and then, after the removal of levonorgestrel-releasing intrauterine system, dilatation and curettage will be done. The biopsy findings will be compared. The primary endpoint is to compare the pathological outcome of endometrial aspiration with dilatation and curettage. The secondary endpoint is the response rate with three types of progestin treatment at 6 months.
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul.
authors.forename: Mi Kyoung
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul sjseongcheil@naver.com.
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.affiliation: Department of Obstetrics and Gynecology, SMG-SNU Boramae Medical Center, Seoul.
authors.forename: Taek Sang
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul.
authors.forename: Kyung-Do
authors.initials: KD
authors.lastname: Ki
authors.affiliation: Center for Uterine Cancer and Gynecologic Cancer Branch, National Cancer Center, Goyang.
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.affiliation: Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul.
authors.forename: Yun Hwan
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam.
authors.forename: Kidong
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
authors.forename: Won Duk
authors.initials: WD
authors.lastname: Joo
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003475:Curettage; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000188:drug therapy*; D004717:Endometrium / Q000601:surgery; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000627:therapeutic use*; D008525:Medroxyprogesterone / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel; D008525:Medroxyprogesterone
keywords: LNG-IUS; dilatation and curettage; endometrial aspiration biopsy; endometrial hyperplasia; progesterone