Levonorgestrel-Releasing IUD May Benefit in Early-Grade Endometrial Cancer

Majority of women responded well and returned to normal histology in six months
Majority of women responded well and returned to normal histology in six months

HealthDay News — A levonorgestrel-releasing intrauterine device (LNG-IUD) is effective in the majority of patients undergoing conservative treatment for low-risk endometrial cancer and complex atypical hyperplasia, according to a case-series study published online December 4 in Obstetrics & Gynecology.

Navdeep Pal, MBBS, MPH, from the University of Texas MD Anderson Cancer Center in Houston, and colleagues retrospectively reviewed 46 cases treated with the LNG-IUD for complex atypical hyperplasia or early-grade endometrial cancer from January 2003 to June 2013. 

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The researchers found that 15 of the 32 evaluable patients at the 6-month time point had complex atypical hyperplasia (47%), 9 had G1 endometrial cancer (28%), and 8 had grade 2 endometrial cancer (25%). At 6 months, the overall response rate was 75% (80% in complex atypical hyperplasia, 67% in grade 1 endometrial cancer, and 75% in grade 2 endometrial cancer). There was a trend toward an association between lack of exogenous progesterone effect in the pathology specimen and nonresponse to the IUD (P=0.05). In women who did not respond to the IUD, median uterine diameter was 1.3 cm larger (P=0.04).

"Levonorgestrel-releasing IUD therapy for the conservative treatment of complex atypical hyperplasia or early-grade endometrial cancer resulted in return to normal histology in a majority of patients," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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