在这项研究中，我们评估了延长孕激素治疗对非典型子宫内膜增生 (AEH) 患者的作用，这些患者在孕激素治疗至少 3 个月后未实现完全消退 (CR)。还评估了预测疾病消退和复发的可能预后因素。我们回顾性地鉴定了在韩国和台湾的两个三级中心接受至少 3 个月的孕激素治疗后经组织学证实有持续性疾病的患者。临床病理因素和临床结果是从病历中获得的。采用Logistic回归分析协变量与CR和复发概率之间的关系。纳入52名患者。 52 名患者中的 37 名 (71.2%) 在长期孕激素治疗后达到 CR。从开始孕激素治疗到 CR 的中位时间为 12.0 个月。每日服用醋酸甲羟孕酮≥200 mg或醋酸甲地孕酮≥80 mg与较高的消退概率相关。 37 名患者中有 19 名（51.4%）出现复发，从 CR 到复发的中位时间为 15.0 个月。体重指数≥27与较高的复发概率相关。 16 名疾病进展为子宫内膜癌的患者中有 12 名接受了手术。 12例肿瘤为I期，无疾病生存。对于孕激素没有初始反应的AEH患者，延长孕激素疗程是可行的。较高的每日孕激素剂量与较高的 CR 概率相关，而肥胖与较高的复发风险相关。对孕激素没有初始反应且 AEH 进展为子宫内膜癌的患者预后良好。© 2025。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

In this study, we evaluated the role of prolonged progestin treatment on atypical endometrial hyperplasia (AEH) patients who did not achieve complete regression (CR) after at least 3 months of progestin treatment. Possible prognostic factors predicting disease regression and recurrence were also assessed.We retrospectively identified patients who had histologically confirmed persistent disease after at least 3 months of progestin treatment at two tertiary centers in Korea and Taiwan. Clinicopathologic factors and clinical outcomes were obtained from medical records. Logistic regression was used to analyze the relationship between covariates and the probability of CR and relapse.Fifty-two patients were included. Thirty-seven of 52 patients (71.2%) achieved CR after prolonged progestin treatment. Median time from starting progestin treatment to CR was 12.0 months. Daily administration of medroxyprogesterone acetate ≥200 mg or megestrol acetate ≥80 mg was associated with higher probability of regression. Nineteen of 37 patients (51.4%) experienced recurrence, with median time from CR to relapse of 15.0 months. Body mass index ≥27 was associated with higher relapse probability. Twelve of 16 patients with disease progression to endometrial carcinoma underwent surgery. The 12 cases had stage I tumors and lived without disease.Extension of progestin treatment course is feasible for AEH patients without an initial response to progestin. Higher daily progestin dosage was associated with higher probability of CR, and obesity was associated with higher risk of relapse. The patients without an initial response to progestins and whose AEH progressed to endometrial carcinoma had good prognoses.© 2025. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.