Gallos, Ioannis D (2014). Management & prognosis of endometrial hyperplasia. University of Birmingham. M.D.
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Gallos14MD.pdf
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Abstract
This thesis investigates the management and prognosis of endometrial hyperplasia. The literature on conservative therapies for endometrial hyperplasia is systematically reviewed and a meta-analysis is performed to identify the most effective treatment. Further meta-analysis is performed for young women with severe endometrial hyperplasia or cancer to explore the effectiveness of fertility-sparing treatment. A national survey of Gynaecologists is performed to evaluate current and the need for further research. A large cohort study is included that defines the regression and relapse of endometrial hyperplasia with two popular conservative therapies, the Levonorgestrel-releasing intrauterine system (LNG-IUS) and oral progestogens. The LNG-IUS is found to induce regression more often with fewer events of relapse than oral progestogens. A prediction model based on clinical characteristics and biomarkers finds that morbid obesity is an independent predictor for relapse. This research has major implications for clinical practice and a national guideline in process is based on its findings.
| Type of Work: | Thesis (Higher Doctorates > M.D.) | |||||||||
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| Award Type: | Higher Doctorates > M.D. | |||||||||
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| College/Faculty: | Colleges (2008 onwards) > College of Medical & Dental Sciences | |||||||||
| School or Department: | School of Clinical and Experimental Medicine | |||||||||
| Funders: | None/not applicable | |||||||||
| Subjects: | R Medicine > R Medicine (General) | |||||||||
| URI: | http://etheses.bham.ac.uk/id/eprint/5157 |
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