Pal N, et al. - The efficacy of the levonorgestrel-releasing intrauterine device (LNG-IUD) was evaluated for the treatment of complex atypical hyperplasia or low-grade endometrial cancer. For the conservative treatment of complex atypical hyperplasia or early-grade endometrial cancer, levonorgestrel-releasing intrauterine device therapy resulted in a return to normal histology in a majority of patients.

Methods

• The researchers performed this retrospective case series included all patients treated with the LNG-IUD for complex atypical hyperplasia or early-grade endometrial cancer from January 2003 to June 2013.
• They calculated response rates and determined the association of response with clinicopathologic factors, including age, body mass index, and uterine size.

Results

• The researchers treated 46 patients with the LNG-IUD, who presented with complex atypical hyperplasia or early-grade endometrial cancer.
• Among the 32 evaluable patients at the 6-month time point, 15 had complex atypical hyperplasia (47%), 9 had G1 endometrial cancer (28%), and 8 had grade 2 endometrial cancer (25%).
• At 6 months, overall response rate was 75% (95% CI 57-89); 80% (95% CI 52-96) in complex atypical hyperplasia, 67% (95% CI 30-93) in grade 1 endometrial cancer, and 75% (CI 35-97) in grade 2 endometrial cancer.
• A trend was noted towards the association of lack of exogenous progesterone effect in the pathology specimen with nonresponse to the IUD (P=.05).
• In women who did not respond to the IUD (P=.04), the median uterine diameter was 1.3 cm larger.