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Purpose: To evaluate the efficacy of transvaginal ultrasonography (TVUS) as a tool for selection and prospective surveillance of patients younger than 40 years undergoing hormonal uterus-sparing therapy for atypical endometrial hyperplasia (AEH) and endometrial cancer (EC). Methods: From February 2006 to July 2014, patients younger than 40 with AEH and EC, referred to the European Institute of Oncology for conservative management, were enrolled in a prospective observational study, consisting of insertion of a levonorgestrel-releasing intrauterine device (LNG-IUD) for 1 year with GnRH analogue administration for 6 months. TVUS was performed every 3 months, to assess endometrial thickness, any signs of myometrial infiltration and ovarian morphology. Endometrial biopsy was performed at 6 and 12 months. Results: 16 patients with AEH and 32 with well-differentiated EC were enrolled. Myometrial infiltration was correctly identified in 6 cases of EC at instrumental pre-treatment evaluation (66.7% at TVUS and 66.7% at MRI). Overall the reduction of endometrial thickness was of 6.0±5.6 (52.6%) and 6.8±6.2 (59.6%) millimeters at 6 and 12 months, respectively, compared to baseline (P |
