부산대학교 도서관

Simple Summary: The rate of concurrent endometrial cancer (EC) in women with atypical endometrial hyperplasia (AEH) is not negligible. Furthermore, among women with EC, about 12% may have a high-risk disease requiring lymph node status assessment. Given that endometrial sampling cannot exclude EC in women with AEH, knowing variables that increase the risk of malignancy can be helpful in clinical practice. Some patient characteristics were associated with this occurrence, representing possible risk factors on which to adjust treatment planning. No prediction models with internal validation showed the impact of patient characteristics in predicting EC after a preoperative diagnosis of AEH. The present study, using regressions and artificial neural networks, found recurrent patient characteristics in women with EC. However, they likely do not contain good/optimal discriminating information. Future predictive models should include other individual factors (e.g., genotypic variables) to move toward more personalized medicine. Background: The rate of concurrent endometrial cancer (EC) in atypical endometrial hyperplasia (AEH) can be as high as 40%. Some patient characteristics showed associations with this occurrence. However, their real predictive power with related validation has yet to be discovered. The present study aimed to assess the performance of various models based on patient characteristics in predicting EC in women with AEH. Methods: This is a retrospective multi-institutional study including women with AEH undergoing definitive surgery. The women were divided according to the final histology (EC vs. no-EC). The available cases were divided into a training and validation set. Using k-fold cross-validation, we built many predictive models, including regressions and artificial neural networks (ANN). Results: A total of 193/629 women (30.7%) showed EC at hysterectomy. A total of 26/193 (13.4%) women showed high-risk EC. Regression and ANN models showed a prediction performance with a mean area under the curve of 0.65 and 0.75 on the validation set, respectively. Among the best prediction models, the most recurrent patient characteristics were age, body mass index, Lynch syndrome, diabetes, and previous breast cancer. None of these independent variables showed associations with high-risk diseases in women with EC. Conclusions: Patient characteristics did not show satisfactory performance in predicting EC in AEH. Risk stratification in AEH based mainly on patient characteristics may be clinically unsuitable. [ABSTRACT FROM AUTHOR]