Table 1. General characteristics of the study population.
| Variables | Total | Progestin-insensitive patients | Progestin-sensitive patients | p-value* | |
|---|---|---|---|---|---|
| Patient (No.) | 338 | 82 | 256 | ||
| Age (yr) | 32 (20–49) | 32 (20–43) | 32 (21–49) | 0.981 | |
| Initial pathological diagnosis | |||||
| EEC | 75 (22.2) | 23 (28.0) | 52 (20.3) | 0.142 | |
| AEH | 263 (77.8) | 59 (72.0) | 204 (79.7) | ||
| Hypertension | 63 (18.6) | 15 (18.3) | 48 (18.8) | 0.926 | |
| Diabetes mellitus† | 22 (6.5) | 5 (6.1) | 17 (6.7) | 0.857 | |
| Nulliparous† | 257 (76.0) | 65 (79.3) | 192 (75.0) | 0.495 | |
| BMI (kg/m2) | 24.18 (15.63–44.06) | 25.82 (15.63–44.06) | 23.62 (15.94–37.65) | 0.003 | |
| BMI≥28 | 93 (27.5) | 34 (41.5) | 59 (23.0) | 0.001 | |
| BMI<28 | 245 (72.5) | 48 (58.5) | 197 (77.0) | ||
| HOMA-IR | 2.26 (0.44–16.50) | 2.59 (0.44–16.50) | 2.20 (0.44–13.03) | 0.017 | |
| HOMA-IR≥2.95 | 129 (38.2) | 38 (46.3) | 91 (35.5) | 0.080 | |
| HOMA-IR<2.95 | 209 (61.8) | 44 (53.7) | 165 (64.5) | ||
| Waist-hip ratio | 0.86 (0.65–1.12) | 0.87 (0.72–1.05) | 0.85 (0.65–1.12) | 0.009 | |
| ≥0.85 | 190 (56.2) | 55 (67.1) | 135 (52.7) | 0.023 | |
| <0.85 | 148 (43.8) | 27 (32.9) | 121 (47.3) | ||
| CA125 (U/mL)† | 17.50 (1.37–819.50) | 17.09 (4.66–72.80) | 17.50 (1.37–819.50) | 0.965 | |
| HE-4 (pmol/mL)† | 44.70 (2.04–107.00) | 46.05 (2.04–102.90) | 43.20 (3.50–107.00) | 0.038 | |
| Estradiol (pg/mL)† | 54 (1–1,237) | 52 (3–778) | 54 (1–1,237) | 0.535 | |
| Progesterone (ng/mL)† | 0.43 (0.01–67.50) | 0.43 (0.01–12.85) | 0.45 (0.01–67.50) | 0.288 | |
| Total testosterone (ng/mL)† | 0.39 (0.01–45.00) | 0.35 (0.01–1.19) | 0.40 (0.01–45.00) | 0.215 | |
| MS† | 140 (41.4) | 32 (39.0) | 108 (42.4) | 0.595 | |
| Lesion size (cm)† | |||||
| ≤2 | 135 (47.7) | 25 (34.2) | 110 (52.4) | 0.008 | |
| >2 | 148 (52.3) | 48 (65.8) | 100 (47.6) | ||
| Treatment options | 0.567 | ||||
| MA/MPA | 181 (53.6) | 42 (51.2) | 139 (54.3) | ||
| MA/MPA + metformin | 112 (33.1) | 30 (36.6) | 82 (32.0) | ||
| MA/MPA + LNG-IUS | 27 (8.0) | 4 (4.9) | 23 (9.0) | ||
| LNG-IUS | 12 (3.6) | 4 (4.9) | 8 (3.1) | ||
| Others | 6 (1.8) | 2 (2.4) | 4 (1.6) | ||
| Median treatment duration to CR (mo)‡ | 6.0 (5.5–6.5) | 14.0 (12.9–15.1) | 5.0 (4.6–5.4) | ||
| 1-year cumulative CR rate (%)‡ | 84.2 | 33.1 | 100 | <0.001 | |
| 2-year cumulative CR rate (%)‡ | 98.6 | 94.1 | 100 | <0.001 | |
| Median follow-up duration after CR (mo) | 25 (0–86) | 16 (0–56) | 27 (0–86) | <0.001 | |
| 1-year relapse-free survival after CR (%)‡ | 92.5 | 85.1 | 93.8 | 0.061 | |
| Pregnancy rate§ | 60/127 (47.2) | 9/23 (39.1) | 51/104 (49.0) | 0.389 | |
| Live birth rate | 48/60 (80.0) | 7/9 (77.8) | 41/51 (80.4) | 0.857 | |
| Method of conception | 0.081 | ||||
| Spontaneous conception | 37/178 (20.7) | 6/31 (19.4) | 31/147 (21.1) | ||
| Ovulation induction | 36/178 (20.2) | 2/31 (6.5) | 34/147 (23.3) | ||
| In-vitro fertilization | 105/178 (59.0) | 23/31 (74.2) | 82/147 (55.8) | ||
Data are shown as number (%) or median (range); treatment duration is shown as median, range. p-value: comparison between progestin-insensitive and progestin-sensitive group.
AEH, atypical endometrial hyperplasia; BMI, body mass index; CR, complete response; EEC, endometrioid endometrial cancer; HE-4, human epididymis protein 4; HOMA-IR, homeostasis model assessment-insulin resistance; LNG-IUS, levonorgestrel intrauterine system; MA, megestrol acetate; MPA, medroxyprogesterone acetate; MS, metabolic syndrome.
*P value for comparison between progestin-insensitive patients and progestin-sensitive patients. †All variables were analyzed among 341 patients except for diabetes mellitus, nulliparous, CA125, HE-4, estradiol, progesterone, total testosterone and MS. Missing data for 5 cases for diabetes mellitus, 2 for Nulliparous, 31 for CA125, 51 for HE-4, 7 for estradiol, 11 for progesterone, 12 for total testosterone, 1 for MS and 55 for Lesion size. ‡Median treatment duration to CR, 1-year cumulative CR rate, 2-year cumulative CR rate and 1-year relapse-free rate after CR were performed by Kaplan-Meier analysis. And median treatment duration to CR is presented as the treatment duration when the estimated CR rate is 50% and 95% confidence interval. §Pregnant rate within 16 months after CR.