Prognostic factors of regression and relapse of complex atypical hyperplasia and well-differentiated endometrioid carcinoma with conservative treatment

- Conservative treatment may be recommended in selected women with endometrial tumors.
- None of the factors studied was associated with higher regression probability.
- Obesity was associated with higher relapse probability.

ObjectiveTo evaluate possible prognostic factors regarding regression and relapse of complex atypical hyperplasia (CAH) and well-differentiated endometrioid adenocarcinoma (WDC) treated with conservative treatment.MethodsThe retrospective study reviewed clinicopathologic, treatment, regression and relapse data from patients diagnosed with CAH or WDC who were treated with conservative treatment at 4 institutions. Potential factor evaluation was performed. SPSS 16 was used for statistical analyses.ResultsEighty-eight patients were included (51 had WDC, and 37 had CAH). Regression was evaluated in 88 patients, with a median follow-up of 61 (range 15-95) months. Seventy-seven (87.5%) patients regressed, and 11 (12.5%) had persistent or progressive disease. Univariate and multivariate analyses showed no factors associated with regression. Relapse was evaluated in 71 patients, with median follow-up of 54 (range 8-86) months. Twenty-five/71 (35.2%) patients experienced relapse. On univariate analysis, body mass index (BMI) 30 or higher (p = 0.001), WCD at initial biopsy (p = 0.017) and positive expression of post-treatment ki67 (p = 0.033) were associated to a higher relapse probability. However, only BMI 30 or higher was significant on multivariate analysis (p = 0.012). The Kaplan-Meier analysis revealed a higher relapse probability in the patients with BMI 30 or higher (p = 0.001).ConclusionObesity seems to be a risk factor for relapse of CAH or WDC with conservative treatment.