Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma : We can hope, at least
© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics..
BACKGROUND: In women with recurrent disease who were conservatively treated for atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EEC), the reasons why conservative treatment was chosen persist and outcomes of performing a conservative re-treatment are unclear, as pooled estimates on oncologic outcomes of such a re-treatment are lacking.
OBJECTIVES: To provide pooled estimates of oncologic outcomes of conservative re-treatment in women with recurrent AEH or EC.
SEARCH STRATEGY: A systematic review and meta-analysis was performed by searching six electronic databases from their inception to March 2022.
SELECTION CRITERIA: Studies that allowed extraction of data about oncologic outcomes of conservative re-treatment of women with recurrent AEH and EEC after a conservative treatment.
DATA COLLECTION AND ANALYSIS: Pooled prevalence of complete response (CR), poor response (PR), and recurrence after conservative re-treatment was calculated.
MAIN RESULTS: Fifteen studies (12 retrospective and 3 prospective) with 492 women (42.1% AEH and 57.9% EEC) were included in the systematic review, and 10 studies (8 retrospective and 2 prospective) were suitable for the meta-analysis. Pooled prevalence was 85.3% (95% confidence interval [CI] 77.0%-91.0%) for CR, 14.7% (95% CI 9.0%-23.0%) for PR, and 40.4% (95% CI 15.5%-71.4%) for recurrence.
CONCLUSIONS: Conservative re-treatment in AEH or EC recurrent women has a high CR rate and acceptable recurrence rate that might allow it to be considered a safe and viable option, at least as a first round of conservative treatment. Women with an unsatisfied desire for motherhood or with high surgical risk might avoid hysterectomy and attempt childbearing or spare high-risk surgery.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:165 |
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| Enthalten in: |
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics - 165(2024), 2 vom: 17. Apr., Seite 542-551 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Raffone, Antonio [VerfasserIn] |
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| Links: |
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| Themen: |
Cancer |
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| Anmerkungen: |
Date Completed 17.04.2024 Date Revised 17.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ijgo.15146 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Raffone, Antonio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma |b We can hope, at least |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 17.04.2024 | ||
| 500 | |a Date Revised 17.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. | ||
| 520 | |a BACKGROUND: In women with recurrent disease who were conservatively treated for atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EEC), the reasons why conservative treatment was chosen persist and outcomes of performing a conservative re-treatment are unclear, as pooled estimates on oncologic outcomes of such a re-treatment are lacking | ||
| 520 | |a OBJECTIVES: To provide pooled estimates of oncologic outcomes of conservative re-treatment in women with recurrent AEH or EC | ||
| 520 | |a SEARCH STRATEGY: A systematic review and meta-analysis was performed by searching six electronic databases from their inception to March 2022 | ||
| 520 | |a SELECTION CRITERIA: Studies that allowed extraction of data about oncologic outcomes of conservative re-treatment of women with recurrent AEH and EEC after a conservative treatment | ||
| 520 | |a DATA COLLECTION AND ANALYSIS: Pooled prevalence of complete response (CR), poor response (PR), and recurrence after conservative re-treatment was calculated | ||
| 520 | |a MAIN RESULTS: Fifteen studies (12 retrospective and 3 prospective) with 492 women (42.1% AEH and 57.9% EEC) were included in the systematic review, and 10 studies (8 retrospective and 2 prospective) were suitable for the meta-analysis. Pooled prevalence was 85.3% (95% confidence interval [CI] 77.0%-91.0%) for CR, 14.7% (95% CI 9.0%-23.0%) for PR, and 40.4% (95% CI 15.5%-71.4%) for recurrence | ||
| 520 | |a CONCLUSIONS: Conservative re-treatment in AEH or EC recurrent women has a high CR rate and acceptable recurrence rate that might allow it to be considered a safe and viable option, at least as a first round of conservative treatment. Women with an unsatisfied desire for motherhood or with high surgical risk might avoid hysterectomy and attempt childbearing or spare high-risk surgery | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a cancer | |
| 650 | 4 | |a endometrium | |
| 650 | 4 | |a fertility‐sparing | |
| 650 | 4 | |a pregnancy | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a risk assessment | |
| 650 | 4 | |a tumor | |
| 700 | 1 | |a Raimondo, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Rovero, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Travaglino, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Lopez, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Di Maio, Carlo Michele |e verfasserin |4 aut | |
| 700 | 1 | |a Neola, Daniele |e verfasserin |4 aut | |
| 700 | 1 | |a Raspollini, Arianna |e verfasserin |4 aut | |
| 700 | 1 | |a Renzulli, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Filippelli, Amelia |e verfasserin |4 aut | |
| 700 | 1 | |a Casadio, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Seracchioli, Renato |e verfasserin |4 aut | |
| 700 | 1 | |a Guida, Maurizio |e verfasserin |4 aut | |
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