Diabetes mellitus and responsiveness of endometrial hyperplasia and early endometrial cancer to conservative treatment.

The conservative treatment of endometrial hyperplasia without atypia (HWA), atypical endometrial hyperplasia (AH/EIN) and early endometrioid carcinoma (EEC) is based on progestins. We aimed to assess whether diabetes mellitus affects the responsiveness of HWA, AH/EIN and EEC to conservative treatment, through a systematic review and meta-analysis. Electronic databases were searched for studies assessing the outcome of conservative treatment in HWA, AH/EIN and EEC, stratified based on the diagnosis of diabetes mellitus. The association of diabetes mellitus with treatment failure was assessed by using odds ratio (OR). A -value  < .05 was considered significant. The risk of publication bias was assessed by using a funnel plot. A subgroups analyses was performed based on histologic diagnosis of benignity (HWA) or premalignancy/malignancy (AH/EIN or EEC). Six studies with 876 patients (383 HWA, 365 AH/EIN and 128 EEC) were included. Overall, diabetes mellitus was not associated with outcome of treatment (OR = 1.20;  = .62). The association was not significant in both the HWA subgroup (OR = 0.95;  = .93) and in AH/EIN and EEC subgroup (OR = 1.43;  = .46). There was no significant risk of publication bias. Diabetes mellitus does not affect the outcome of conservative treatment in HWA, AH/EIN and EEC.