Article Text

Download PDFPDF

345 Clinical parameters predicting risk of concurrent invasive carcinoma and high-risk carcinoma in patients with endometrial intraepithelial neoplasia
  1. Nazlı Orhan1,
  2. Raziye Melike Yildirim1,
  3. Halise Meltem Batur1,
  4. Utku Akgor2,
  5. Nejat Ozgul1,
  6. Murat Gultekin1 and
  7. Mehmet Coskun Salman1
  1. 1Hacettepe University Faculty of Medicine; Department of Obstetrics and Gynaecology
  2. 2Hacettepe University Faculty of Medicine; Department of Gynecological Oncology; Department of Obstetrics and Gynaecology


Introduction/Background Endometrial intraepithelial neoplasia (EIN) is a premalignant lesion, but risk of concurrent endometrial adenocarcinoma (EAC) is also high. Although most patients with EIN diagnosed with concurrent EAC will have low risk disease, some will have high-risk disease who require. Clinical characteristics may help determine such patients.

Methodology Patients with a diagnosis of EIN who were operated at Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynaecology were identified. The rate of concurrent EAC and high-risk EAC were determined. Preoperative characteristics were reviewed in order to determine the predictors of concurrent malignancy.

Results A total of 252 patients constituted study group. Mean age was 46.6 years and 43.7% were postmenopausal. 44.0% had co-existing one or more medical diseases while 14.3% had diabetes, 19.5% had hypertension, and 7.5% had both. The most common surgery was total hysterectomy with or without adnexal removal performed in 93.6% of patients. Frozen section was requested for 82.5% of patients. Final pathology revealed EAC in 17.5%, but only 4.4% had high-risk disease. The accuracy of frozen section for predicting final pathology in terms of the presence or absence of EAC was 89.4%. Patient with malignancy tend to be significantly older (47.4 vs. 54.1 years, p=0.02) and risk of malignancy was significantly higher in postmenopausal women (9.2% vs 28.2%, p<0.001) and in women with hypertension (13.8% vs 32.7%, p=0.02). similarly, patients with high-risk disease were significantly older (48.2 vs. 58.2 years, p=0.01) and this risk was higher in postmenopausal women (1.4% vs. 8.2%, p=0.01) and women with hypertension (3.0% vs. 10.2%, p=0.04).

Conclusion Surgery is the mainstay of treatment in patients with EIN. During surgery, frozen section evaluation should be requested since a significant proportion of patients have concurrent EAC and frozen section is highly effective in determining these patients. Although rare, some patients may have concurrent high-risk endometrial carcinoma necessitating surgical staging. Both concurrent invasive carcinoma and high-risk disease are associated with older age, being in postmenopausal period, and having hypertension.

Disclosures No potential conflict of interest to declare.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.