Clinical outcomes following the use of levonorgestrel intrauterine device in women with endometrial intraepithelial neoplasia or adenocarcinoma in an urban tertiary care network: A 10-year retrospective study

Document Type

Conference Proceeding

Publication Date

9-1-2025

Publication Title

Gynecol Oncol

Abstract

Objectives: This study aimed to evaluate the outcomes associated with the use of levonorgestrel intrauterine device (LNG-IUD) for the treatment of endometrial intraepithelial neoplasia (EIN) or clinically early-stage, low-grade endometrial adenocarcinoma (EAC) as well as to assess for disparities in treatment among these patients. Methods: This was an IRB-approved (#16373) retrospective chart review. All patients who received LNG-IUD for treatment of EIN or EAC from January 2013 through January 2023 were included in this study and were identified through a retrospective chart review. N(%) was used to summarize the categorical data, while median (IQR) was used for continuous data. Kruskal-Wallis rank sum test and Fisher's exact test were applied to examine disparities between groups. Statistical significance was prespecified at P < 0.05. All analyses were performed using R 4.3.2. Results: In total, 88 patients were identified during the study period, however, 15 were excluded from the final analysis due to incomplete data. In the analysis group at the time of the first resampling visit, which was a median of 189.0 days (127.5, 219.0) from IUD insertion, 27 (58.7 %) of those patients who were resampled showed an appropriate treatment response. The median number of resampling visits was 1.0 (0.0, 2.0) and 27 patients (58.7 %) were never resampled after IUD insertion. There were only 28 surgical candidates (38.4 %) in this group and of those patients, 15 underwent definitive management with hysterectomy. Those of younger age were significantly more likely to have 3+ resampling visits when compared to those of older age (P = 0.014). Additionally, those who self-identified as white or Black were significantly more likely to have 3+ and 1 resampling visit, respectively (P = 0.013). Conclusions: The initial outcomes in this population are in line with previous studies for patients treated with progestins, however, most patients were never reevaluated after IUD insertion. There are significantly different follow-up rates when examined by both age and race. Further investigation is required to determine additional factors that may contribute to this disparity. When using this treatment modality, it is important to establish a protocol to ensure guideline-concordant follow-up for all patients. [Formula presented]

Volume

200

First Page

163

Last Page

164

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