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Risk of endometrial cancer in asymptomatic postmenopausal patients with thickened endometrium: data from the FAME-Endo study: an observational register study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the risk for endometrial cancer (EC) in a large series of asymptomatic patients with thickened endometrium at ultrasound examination based on previously published data of a theoretical cohort.

Methods

In a prospective register study, a total of 1024 women with thickened endometrium in ultrasound examination undergoing histological diagnosis by dilation, hysteroscopy and curettage were evaluated. 124 patients were excluded due to current medication with tamoxifen and/or presence of HNPCC leaving 900 patients for further analysis.

Results

Mean [standard deviation (SD)] age of patients was 65.6 (8.6) years. Mean (SD) endometrial thickness was 11.9 (5.8) mm. 32 and 6 cases of EC and complex endometrial hyperplasia with atypia were found, respectively. In the univariate analysis, a statistically significant association between endometrial thickness, current use of antihypertensive medication, number of deliveries, and the presence of endometrial fluid in preoperative vaginal ultrasound (p < 0.05) with EC was found. A multivariate logistic regression model incorporating these parameters showed a statistically significant independent association of endometrial thickness, number of deliveries, and the presence of endometrial fluid in preoperative vaginal ultrasound (p < 0.05), but not current use of antihypertensive medication, with EC. Using a cut-off of the endometrial thickness of > 11 mm, the risk for “EC alone” and “EC and complex endometrial hyperplasia with atypia combined” was found to be 6.7% and 7.9%, respectively.

Conclusions

Our data compare favorably to a theoretical cohort suggesting a clinically reasonable cut-off of > 11 mm endometrial thickness to discriminate between “normal” and “pathological”. The data regarding “risk for endometrial cancer” can be used for counseling affected women.

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Author information

Author notes

  1. Lukas Hefler and Judith Lafleur contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Gynecological Cancer Center, Ordensklinikum Linz, Seilerstaette 2-4, 4010, Linz, Austria

    Lukas Hefler & Judith Lafleur

  2. Karl Landsteiner Institute of Gynecolgical Surgery and Oncology, Seilerstaette 2-4, Linz, Austria

    Lukas Hefler & Judith Lafleur

  3. Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria

    Sonja Kickmaier & Alexander Reinthaller

  4. Department of Obstetrics and Gynecology, Landeskrankenhaus Klagenfurt, Feschnigstraße 11, Klagenfurt, Austria

    Heinz Leipold

  5. Department of Obstetrics and Gynecology, Landeskrankenhaus Oberpullendorf, Spitalgasse 32, Oberpullendorf, Austria

    Carmen Siebenhofer

  6. Department of Obstetrics and Gynecology, Medical University of Salzburg, Müllner Hauptstraße 48, Salzburg, Austria

    Barbara Tringler

  7. Department of Gynecology, Konventhospital Barmherzige Brueder, Marschallgasse 12, Graz, Austria

    Christian Schauer

  8. Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstraße 35, Innsbruck, Austria

    Alexandra Ciresa-König

Authors
  1. Lukas Hefler
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  2. Judith Lafleur
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Contributions

LH: Protocol/project development, Data analysis, Manuscript writing/editing. JL: Data collection or management, Protocol/project development, Data analysis, Manuscript writing/editing. SK: Data collection or management. HL: Data collection or management. CS: Data collection or management. BT: Data collection or management. CS: Data collection or management, Manuscript editing. AC-K: Data collection or management. AR: Protocol/project development Data collection or management, Manuscript editing.

Corresponding author

Correspondence to Lukas Hefler.

Ethics declarations

Ethical approval

Approval for this study was obtained by the respective Institutional Review Boards (EK 484/2009).

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Formal consent

For this type of study formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Hefler, L., Lafleur, J., Kickmaier, S. et al. Risk of endometrial cancer in asymptomatic postmenopausal patients with thickened endometrium: data from the FAME-Endo study: an observational register study. Arch Gynecol Obstet 298, 813–820 (2018). https://doi.org/10.1007/s00404-018-4885-3

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  • DOI: https://doi.org/10.1007/s00404-018-4885-3

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