title: Management of Endometrial Hyperplasia With a Levonorgestrel-Releasing Intrauterine System: A Korean Gynecologic-Oncology Group Study.
abstract: OBJECTIVE
  The aim of the study was to evaluate the efficacy of the levonorgestrel intrauterine system (LNG-IUS) for treatment of endometrial hyperplasia (EH).
  
  
  METHODS
  A prospective multicenter study was conducted from November 2010 to March 2014. Patients with histologically confirmed EH were treated with LNG-IUS. At 3, 6, and 9 months after LNG-IUS insertion, follow-up endometrial aspiration biopsies with the LNG-IUS in the uterus were undertaken. At the 12th month of follow-up, endometrial tissues were obtained via 2 methods: endometrial aspiration biopsy with the LNG-IUS in the uterus, followed by dilatation and curettage (D&C) after LNG-IUS removal. The primary outcome was the regression rate at 12 months after LNG-IUS insertion, and the secondary outcome was the consistency of the results between the endometrial aspiration biopsy and the D&C.
  
  
  RESULTS
  The study population comprised 75 patients, including 37 with simple hyperplasia without atypia; 3 with atypical simple hyperplasia; 23 with complex hyperplasia without atypia, and 12 with atypical complex hyperplasia. Of these patients treated with the LNG-IUS, 38 (50.7%) were followed up at 12 months after LNG-IUS insertion. The complete regression rate at 12 months was 94.7% (36/38): 100% (6/6) of patients with atypical EH and 93.7% (30/32) with EH without atypia. In all of the cases (100%, 36/36), patients achieved complete regression within 3 months of LNG-IUS insertion. A comparison of the pathologic results from endometrial aspiration biopsy and D&C was carried out for 15 patients. In the histologic results by endometrial aspiration biopsy, 14 patients were diagnosed as "normal endometrium" and 1 as "insufficient tissue for pathologic evaluation." Among the 14 cases of normal endometrium by endometrial aspiration biopsy, 1 was diagnosed as "residual EH" by D&C, and the 1 case with insufficient tissue was diagnosed as normal endometrium by D&C.
  
  
  CONCLUSIONS
  Levonorgestrel intrauterine system is an effective and favorable method for treatment of EH.
authors.affiliation: *Departments of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University; †Seoul National University College of Medicine, Seoul; ‡Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan; §Chonnam National University Medical School, Gwangju; ∥Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul; ¶Gyeongsang National University School of Medicine, Jinju,; #Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul; **Inha University College of Medicine, Incheon; ††CHA Bundang Medical Center, CHA University, Bundang; ‡‡Ajou University School of Medicine, Suwon; §§Sanggye Paik Hospital, Inje University College of Medicine; and ∥∥Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Mi Kyoung
authors.initials: MK
authors.lastname: Kim
authors.forename: Seok Ju
authors.initials: SJ
authors.lastname: Seong
authors.forename: Jae-Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Seob
authors.initials: S
authors.lastname: Jeon
authors.forename: Ho Sun
authors.initials: HS
authors.lastname: Choi
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Lee
authors.forename: Jong Hak
authors.initials: JH
authors.lastname: Lee
authors.forename: Woong
authors.initials: W
authors.lastname: Ju
authors.forename: Eun Seop
authors.initials: ES
authors.lastname: Song
authors.forename: Hyun
authors.initials: H
authors.lastname: Park
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
authors.forename: Chulmin
authors.initials: C
authors.lastname: Lee
authors.forename: Soon-Beom
authors.initials: SB
authors.lastname: Kang
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D019468:Disease Management; D004714:Endometrial Hyperplasia / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000706:statistics & numerical data*; D016912:Levonorgestrel / Q000008:administration & dosage*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel