What's the resection? What's the pathology? | Figure 1

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What's the resection? What's the pathology?

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Is metformin an effective and safe treatment for people with endometrial hyperplasia?

Endometrial hyperplasia is a precancerous condition in women that can lead to endometrial cancer, if left untreated.
Key results:
Comparisons of metformin versus megestrol acetate have provided insufficient evidence to show differences in effectiveness for curing endometrial hyperplasia. It remains uncertain whether there is any difference between metformin and megestrol acetate in reducing hysterectomy rates or abnormal uterine bleeding in women with endometrial hyperplasia. Although both studies provided data on progression of endometrial hyperplasia to endometrial cancer, there were no events in either arm, and study authors reported no data on adverse effects.
When metformin plus megestrol acetate is compared with megestrol acetate, differences in effectiveness between groups treating endometrial hyperplasia remain unclear. Three of eight patients in the metformin plus megestrol acetate study arm reported nausea. Occurrence of other adverse events is unclear.
Quality of the evidence:
We rated the quality of evidence as very low for all outcomes owing to very serious risk of bias (associated with poor reporting, attrition, and limitations in study design) and imprecision.
Cochrane Review; 3 trials (77 women)