TREATMENT OF PRECURSORS OF ENDOMETRIAL CANCER

From 1985 to 1991, 73 hysterectomies were performed on patients suffer ing from histologically demonstrated adenomatous hyperplasia, grades 1 -3, at the Kiel University Hospital of Gynecology. The operations were done within a month from the diagnosis. Three of the patients were un der 40 years of age. An exact correspondence between the grade of aden omatous hyperplasia in the abraded material and the uterus specimen wa s found in only 44% of the cases. In the patients over 40 with adenoma tous hyperplasia of any grade demonstrated in the abraded material, an already well-differentiated endometrial carcinoma was found in 16% of the cases, while such a carcinoma was found in 57% of the cases with grade 3 adenomatous hyperplasia! Even though drug therapy with gestage n may have a beneficial effect, a hysterectomy is nevertheless the tre atment of choice for adenomatous hyperplasia of grade 2 and grade 3 in patients over 40 because it is not absolutely certain from a diagnost ic point of view that the material is representative of the entire muc osa. In women under 40 years of age it is necessary to plan therapy on an individual basis.