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Endometrial cancer and hormonal therapy (HT)
198
Abstracts / Maturitas 81 (2015) 191–236
Endocervical margins affected: 44 (15.7%): pre: 32 (14.2%) postmenopausal: 12 (21.8%). Reconizations 17 (6%): premenopausal: 14 (6.2%). Postmenopausal: 3 (5.4%). Hysterectomy postcone: 11 (3.9%): premenopausal: 3 (1.3%). Postmenopausal: 8 (14.5%) hysterectomy indications: 3 microinvasive, 3 persistence CIN 2–3 postcone, 5 Adeno insitu. Conclusions: We found no difference between the 2 groups of pre- and postmenopausal women in terms of cone histology and number of reconizations made. In the group of postmenopausal women, we found a large number of endocervical margins affected in the histological study of cone and this result would correspond to a greater number of endocervical lesions in menopausal than in premenopausal women. The other major difference was in the postcone hysterectomies related to high-grade lesions with large endocervical affection, which reach a rate of 15%. http://dx.doi.org/10.1016/j.maturitas.2015.02.285 P145 Endometrial cancer and hormonal therapy (HT) Laura Baquedano Mainar ∗ , Leyre Ruiz Campo, Alberto Lanzon Laga, Miguel Angel Ruiz Conde Hospital Universitario Miguel Servet, Zaragoza, Spain Objectives: To study the clinical and prognosis parameters of endometrial cancer in women with HT. Methods: A retrospective and transversal study between January 2003 until January 2013 included women with hormonal treatment by climateric clinic at the time of diagnosis of endometrial cancer. We analyzed several variables: age, diabetes, HTA, parity, obesity, histological grade, histological type, myometrial invasion, lymphovascular space affectation, size, hormone receptor, Ki67 antigen and FIGO stage. Results: In the period of the study 441 women were treated for endometrial cancer and 12 of them took at this time HT, representing 2.7% of all endometrial carcinomas. The mean age was 55.7 and the parity 1.25; 36% had HTA, 18% diabetes and 54.5% obesity. The mean size was 28.5 mm, the histological grade was 41.7% G1, 25% G2 and 33.3% G3. All of cases except one clear cells were endometriod subtype. 75% had lymphovascular space affectation in the surgical piece of hysterectomy and the hormonal receptors overexpression were positive in 81.8% and the mean of the Ki67 antigen value was 34%. The FIGO stage was early (IA, IB) in 75% of the cases. Conclusions: Endometrial cancers diagnosed in women with menopause hormone therapy are infrequent, often not high grade and not usually associated with bad prognosis parameters as deep myometrial invasion and lymphovascular space affectation, most of them are subtype I and they are often diagnosed in early FIGO stages. http://dx.doi.org/10.1016/j.maturitas.2015.02.286
P146 Causes of postmenopausal bleeding Jorge Fernández Parra 1,∗ , Rebeca Jiménez Alfaro 2 , Antonio Rodríguez Oliver 2 , Aida González Paredes 2 , Ángel Santalla Hernández 2 , Maria Teresa Aguilar Romero 2 , Jose Luis Gallo Vallejo 2 1 Hospital Universitario Virgen de las Nieves de Granada, Obstetrics and Gynecology Department, Granada, Spain 2 Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
Introduction: Postmenopausal bleeding (PMB) is a frequent symptom in menopause, and it is estimated that 1 in every 10 women seek medical attention for it during their lifetime. Vaginal PMB is the most frequent sign of endometrial cancer (90%), which is the most frequent type of gynecological tumor. To establish an appropriate diagnostic strategy it is important to know the frequency of endometrial cancer in women with PMB and hysteroscopy is one of the most effective tests for the diagnosis of abnormal uterine bleeding. Objectives: To determine the causes of bleeding in women with PMB and evaluate the frequency of bleeding recurrence. Methods: We used a prospective descriptive approach to determine the incidence and identify endometrial lesions in women with postmenopausal bleeding making use of hysteroscopy and directed biopsy. In addition, we followed our sample of patients for 5 years to evaluate the incidence and diagnosis of new bleeding episodes. Results: In the 231 women with PMB included in the study we diagnosed 17 cases of endometrial cancer (7.4%). Almost half of the women (47.6%, 110 women) had endometrial polyps, and in 35.1% (81 women) the endometrium was atrophic. Women with proliferative endometrium were younger and the time since menopause was shorter than in women diagnosed as having endometrial cancer or polyps (p < 0.05). There were no differences between groups in mean age of menopause. During follow-up of 202 of the women included in the study, 12 sought medical attention for recurrent bleeding (5.9%), and 3 cases of endometrial carcinoma were diagnosed in these patients. Conclusions: Most postmenopausal women with abnormal uterine bleeding have benign intracavitary lesions. Recurrent bleeding is infrequent but the likelihood that endometrial cancer will be diagnosed is greater than after an initial bleeding episode. http://dx.doi.org/10.1016/j.maturitas.2015.02.287
Abstracts / Maturitas 81 (2015) 191–236
Endocervical margins affected: 44 (15.7%): pre: 32 (14.2%) postmenopausal: 12 (21.8%). Reconizations 17 (6%): premenopausal: 14 (6.2%). Postmenopausal: 3 (5.4%). Hysterectomy postcone: 11 (3.9%): premenopausal: 3 (1.3%). Postmenopausal: 8 (14.5%) hysterectomy indications: 3 microinvasive, 3 persistence CIN 2–3 postcone, 5 Adeno insitu. Conclusions: We found no difference between the 2 groups of pre- and postmenopausal women in terms of cone histology and number of reconizations made. In the group of postmenopausal women, we found a large number of endocervical margins affected in the histological study of cone and this result would correspond to a greater number of endocervical lesions in menopausal than in premenopausal women. The other major difference was in the postcone hysterectomies related to high-grade lesions with large endocervical affection, which reach a rate of 15%. http://dx.doi.org/10.1016/j.maturitas.2015.02.285 P145 Endometrial cancer and hormonal therapy (HT) Laura Baquedano Mainar ∗ , Leyre Ruiz Campo, Alberto Lanzon Laga, Miguel Angel Ruiz Conde Hospital Universitario Miguel Servet, Zaragoza, Spain Objectives: To study the clinical and prognosis parameters of endometrial cancer in women with HT. Methods: A retrospective and transversal study between January 2003 until January 2013 included women with hormonal treatment by climateric clinic at the time of diagnosis of endometrial cancer. We analyzed several variables: age, diabetes, HTA, parity, obesity, histological grade, histological type, myometrial invasion, lymphovascular space affectation, size, hormone receptor, Ki67 antigen and FIGO stage. Results: In the period of the study 441 women were treated for endometrial cancer and 12 of them took at this time HT, representing 2.7% of all endometrial carcinomas. The mean age was 55.7 and the parity 1.25; 36% had HTA, 18% diabetes and 54.5% obesity. The mean size was 28.5 mm, the histological grade was 41.7% G1, 25% G2 and 33.3% G3. All of cases except one clear cells were endometriod subtype. 75% had lymphovascular space affectation in the surgical piece of hysterectomy and the hormonal receptors overexpression were positive in 81.8% and the mean of the Ki67 antigen value was 34%. The FIGO stage was early (IA, IB) in 75% of the cases. Conclusions: Endometrial cancers diagnosed in women with menopause hormone therapy are infrequent, often not high grade and not usually associated with bad prognosis parameters as deep myometrial invasion and lymphovascular space affectation, most of them are subtype I and they are often diagnosed in early FIGO stages. http://dx.doi.org/10.1016/j.maturitas.2015.02.286
P146 Causes of postmenopausal bleeding Jorge Fernández Parra 1,∗ , Rebeca Jiménez Alfaro 2 , Antonio Rodríguez Oliver 2 , Aida González Paredes 2 , Ángel Santalla Hernández 2 , Maria Teresa Aguilar Romero 2 , Jose Luis Gallo Vallejo 2 1 Hospital Universitario Virgen de las Nieves de Granada, Obstetrics and Gynecology Department, Granada, Spain 2 Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
Introduction: Postmenopausal bleeding (PMB) is a frequent symptom in menopause, and it is estimated that 1 in every 10 women seek medical attention for it during their lifetime. Vaginal PMB is the most frequent sign of endometrial cancer (90%), which is the most frequent type of gynecological tumor. To establish an appropriate diagnostic strategy it is important to know the frequency of endometrial cancer in women with PMB and hysteroscopy is one of the most effective tests for the diagnosis of abnormal uterine bleeding. Objectives: To determine the causes of bleeding in women with PMB and evaluate the frequency of bleeding recurrence. Methods: We used a prospective descriptive approach to determine the incidence and identify endometrial lesions in women with postmenopausal bleeding making use of hysteroscopy and directed biopsy. In addition, we followed our sample of patients for 5 years to evaluate the incidence and diagnosis of new bleeding episodes. Results: In the 231 women with PMB included in the study we diagnosed 17 cases of endometrial cancer (7.4%). Almost half of the women (47.6%, 110 women) had endometrial polyps, and in 35.1% (81 women) the endometrium was atrophic. Women with proliferative endometrium were younger and the time since menopause was shorter than in women diagnosed as having endometrial cancer or polyps (p < 0.05). There were no differences between groups in mean age of menopause. During follow-up of 202 of the women included in the study, 12 sought medical attention for recurrent bleeding (5.9%), and 3 cases of endometrial carcinoma were diagnosed in these patients. Conclusions: Most postmenopausal women with abnormal uterine bleeding have benign intracavitary lesions. Recurrent bleeding is infrequent but the likelihood that endometrial cancer will be diagnosed is greater than after an initial bleeding episode. http://dx.doi.org/10.1016/j.maturitas.2015.02.287