Intrauterine Progestin Therapy as a New Approach to Premalignant Endometrial Polyps: A Prospective Observational Study

• Published in: Anticancer research Vol. 39; no. 9; pp. 4897 - 4903
• Main Authors: SLETTEN, ELISE THORESEN, ARNES, MARIT, VEREIDE, ANNE BEATE, ØRBO, ANNE
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.09.2019; International Institute of Anticancer Research (IIAR)
• Subjects: Adult; Aged; Antineoplastic Agents, Hormonal - administration & dosage; Biomarkers; Biopsy; Body mass index; Endometrial Hyperplasia - drug therapy; Endometrial Hyperplasia - pathology; Endometrium; Estrogens; Female; Humans; Hyperplasia; Hysterectomy; Medical disciplines: 700; Medisinske Fag: 700; Microscopy; Middle Aged; Observational studies; Patients; Pilot Projects; Polyps; Polyps - pathology; Precancerous Conditions - drug therapy; Precancerous Conditions - pathology; Progestin; Progestins - administration & dosage; Progestins - adverse effects; Prospective Studies; Risk; Therapy; Treatment Outcome; Uterine cancer; VDP; Berlin Germany; Norway; Germany; Endometrial polyps; LNG-IUS; progestin therapy
• ISSN: 0250-7005; 1791-7530; 1791-7530
• DOI: 10.21873/anticanres.13676

Endometrial hyperplastic polyps (EHP) may progress to endometrial carcinoma (EC) if left untreated. We aimed to prospectively investigate the efficacy of the low-dose levonorgestrel intrauterine system (LNG-IUS) as therapy for EHP with malignant potential. In total, 37 women with EHP underwent therapy with LNG-IUS containing 13.5 mg levonorgestrel for six months or 4-10 weeks depending on whether the EHP was characterized (by D-score analysis) as low- to medium-risk (n=33) or high-risk (n=4) of coexistent or future EC. Therapy response was defined as complete clearance of hyperplastic glands in post-therapy endometrial biopsy. All women with low- to medium-risk EHP obtained therapy response, whereas only 1 out of 4 with high-risk EHP responded to therapy. None of the women were diagnosed with EC during the study and no serious adverse events occurred. Low-dose LNG-IUS represents a promising therapy for selected women with EHP.