Analysis of clinical factors affecting recurrence in patients with atypical endometrial hyperplasia and early endometrial carcinoma with fertility preservation
Objective To investigate the related factors of recurrence in patients with atypical endometrial hyperplasia(AEH)and endometrial carcinoma(EC)after complete remission with fertility preservation.Methods The retrospective study was conducted on 240 patients with EC and AEH who underwent fertility-sparing treatment and initially reached a complete response at Peking University People's Hospital from January 1,2009 to March 1,2023.All patients were followed up for more than 6 months.This study analyzed the factors affecting the recurrence of patients and compared the disease free survival(DFS)time through Kaplan-Meier survival analysis and Log-rank test.Binary logistic regression and Cox survival analysis were used to assess the recurrence.Results The median follow-up time of 240 patients was 44.70 months(23.93 months,80.25 months),and the recurrence rate was 24.58％(59/240).Among them,the recurrence rate of EC was 30.9％(34/110),and that of AEH was 19.2％(25/130).The median DFS time for patients was 19.58 months(10.16 months,41.53 months).Logistic regression analysis showed that pathological type(P=0.014),oral progesterone duration(P=0.024),a body shape index(ABSI)(P=0.009),obesity(P=0.005)and body roundness index(BRI)(P=0.01)were the most influential factors of recurrence in EC and AEH patients after complete remission(CR).K-M survival analysis showed pathological type(P=0.015)and maintenance treatment(P=0.020)showed a significantly lower DFS with statistical significance.Multivariate Cox survival regression analysis suggested that pathological type(P=0.017),ABSI(P=0.003)and obesity(P=0.009)were independent risk factors for recurrence after CR in patients with EC and AEH.Conclusions After CR of EC and AEH after receiving fertility-sparing treatment,pathological type,ABSI,obesity,BRI and maintenance treatment are the risk factors for recurrence.
endometrial carcinomaatypical endometrial hyperplasiafertility-sparing treatmenttumor recurrencebody shape index
万方数据
维普
