To estimate cancer outcome and outcome predictors of women with endometrial intraepithelial neoplasia (EIN).
Methods
Outcomes of women with first diagnosis of EIN (“index biopsy”) was determined by follow-up pathology. Patient characteristics were correlated with EIN regression, EIN persistence, and progression to cancer.
Results
Fifteen percent (9.8-20.8%, 26/177) of index EIN biopsies had concurrent cancer. Of the women with cancer-free index EIN biopsies, and follow-up by hysterectomy or more than 18 months surveillance, 25% (18.4-33.3%, 36/142) showed regression, 35% (27.4-43.7%, 50/142) persistence, and 39% (31.3-48.0%, 56/142) progression. Non-white ethnicity and progestin treatment reduced cancer outcomes (OR 0.16 (0.03,0.84) and 0.24 (0.08, 0.70) respectively), while body mass index (BMI) greater than 25 increased malignant outcomes (BMI 25 or higher, OR 3.05 (1.10,8.45)).
Conclusion
EIN confers a high risk of cancer, but individual patient outcomes cannot be predicted. Management should include exclusion of concurrent carcinoma and consideration of hysterectomy.
