LNG-IUS treatment of non-atypical endometrial hyperplasia in perimenopausal women: a randomized controlled trial
Open Access
- 1 January 2013
- journal article
- Published by Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology and Colposcopy in Journal of Gynecologic Oncology
- Vol. 24 (2), 128-134
- https://doi.org/10.3802/jgo.2013.24.2.128
Abstract
To compare the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) and oral norethisterone acetate (NET) for treatment of non-atypical endometrial hyperplasia in perimenopausal women. One hundred and twenty perimenopausal women with non-atypical endometrial hyperplasia were selected in this randomized controlled trial. Patients received LNG-IUS (n=59) or NET (n=61; 15 mg/day for 3 weeks/cycle) for 3-6 months. Outpatient follow-up with endometrial biopsies were undertaken at 3, 6, and 12 months intervals after treatment. Outcome measures were; the regression rate, the time to regression and hysterectomy rate. A significantly higher regression rate was noted in the LNG-IUS group than in NET group at the 3rd, 6th and 12th month follow-up visits using intention-to-treat analysis (67.8% vs. 47.5%, relative risk [RR], 1.42; 79.7% vs. 60.7%, RR, 1.31; and 88.1% vs. 55.7%, RR, 1.58, respectively). However, no significant difference was found regarding the median time to regression (3 months). The hysterectomy rate during the follow-up period was significantly higher in the NET group (57.4% vs.22%, p<0.001). LNG-IUS treatment of non-atypical endometrial hyperplasia in perimenopausal women is more effective than NET for achieving disease regression for the majority within 1 year. Moreover, it can reduce the number of hysterectomies performed.Keywords
This publication has 38 references indexed in Scilit:
- Oncologic and Reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 Adenocarcinoma: A systematic reviewGynecologic Oncology, 2012
- Levonorgestrel intra-uterine system as a treatment option for complex endometrial hyperplasiaEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 2011
- Management of Endometrial Hyperplasia With a Levonorgestrel-releasing Intrauterine System: Single Arm, Prospective Multicenter Study: Korean Gynecologic Oncology Group Study (KGOG2006)Japanese Journal of Clinical Oncology, 2011
- The effectiveness of levonorgestrel releasing intrauterine system in the treatment of endometrial hyperplasia in Korean womenJournal of Gynecologic Oncology, 2010
- Incidence of endometrial hyperplasiaAmerican Journal of Obstetrics and Gynecology, 2009
- Treatment results of endometrial hyperplasia after prospective D-score classification: A follow-up study comparing effect of LNG-IUD and oral progestins versus observation onlyGynecologic Oncology, 2008
- Concurrent endometrial carcinoma in women with a biopsy diagnosis of atypical endometrial hyperplasiaCancer, 2006
- Risk of progression in complex and atypical endometrial hyperplasia: clinicopathologic analysis in cases with and without progestogen treatmentInternational Journal of Gynecologic Cancer, 2004
- TISSUE CONCENTRATIONS OF LEVONORGESTREL IN WOMEN USING A LEVONORGESTREL‐RELEASING IUDClinical Endocrinology, 1982
- MEASUREMENT OF MENSTRUAL BLOOD LOSS IN PATIENTS COMPLAINING OF MENORRHAGIABJOG: An International Journal of Obstetrics and Gynaecology, 1977