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

Anticancer Res. 2019 Sep;39(9):4897-4903. doi: 10.21873/anticanres.13676.

Abstract

Background/aim: 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.

Patients and methods: 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.

Results: 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.

Conclusion: Low-dose LNG-IUS represents a promising therapy for selected women with EHP.

Keywords: Endometrial polyps; LNG-IUS; progestin therapy.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Biomarkers
  • Endometrial Hyperplasia / drug therapy*
  • Endometrial Hyperplasia / pathology*
  • Female
  • Humans
  • Middle Aged
  • Pilot Projects
  • Polyps / pathology*
  • Precancerous Conditions / drug therapy*
  • Precancerous Conditions / pathology*
  • Progestins / administration & dosage*
  • Progestins / adverse effects
  • Prospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Hormonal
  • Biomarkers
  • Progestins