Management & prognosis of endometrial hyperplasia

[摘要] This thesis investigates the management and prognosis of endometrial hyperplasia. The literature on conservative therapies for endometrial hyperplasia is systematically reviewed and a meta-analysis is performed to identify the most effective treatment.Further meta-analysis is performed for young women with severe endometrial hyperplasia or cancer to explore the effectiveness of fertility-sparing treatment. A national survey of Gynaecologists is performed to evaluate current and the need for further research. A large cohort study is included that defines the regression and relapse of endometrial hyperplasia with two popular conservative therapies, the Levonorgestrel-releasing intrauterine system (LNG-IUS) and oral progestogens. The LNG-IUS is found to induce regression more often with fewer events of relapse than oral progestogens. A prediction model based on clinical characteristics and biomarkers finds that morbid obesity is an independent predictor for relapse. This research has major implications for clinical practice and a national guideline in process is based on its findings.

[发布机构] University:University of Birmingham;Department:School of Clinical and Experimental Medicine

[关键词] R Medicine;R Medicine (General)