Levonorgestrel-releasing intrauterine device therapy versus oral progestin treatment for Reproductive-Aged patients with endometrial intraepithelial neoplasia : a systematic review and Meta-Analysis
© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissionsoup.com..
BACKGROUND: We conducted a systematic review and meta-analysis to examine outcomes of patients with endometrial intraepithelial neoplasia (EIN) treated with oral progestins or levonorgestrel-releasing intrauterine device (LNG-IUD).
METHODS: We conducted a systematic review across five databases to examine outcomes of progestational treatment (oral progestins or LNG-IUD) for patients with EIN. The primary outcome was the best complete response (CR) rate within twelve months of primary progestational treatment. Sensitivity analyses were performed by removing studies with extreme effect sizes. Secondary outcomes included the pooled pregnancy rate.
RESULTS: We identified 21 eligible studies, including 824 premenopausal patients with EIN, for our meta-analysis. Among these, 459 patients received oral progestin, while 365 patients received LNG-IUD as a primary progestational treatment. The pooled best CR proportion within 12 months was 82% (95% CI, 69-91) following oral progestin treatment, and 95% (95% CI, 81-99) following LNG-IUD treatment. After removing outlier studies, the pooled proportion was 86% (95% CI, 75-92) for the oral progestin group, and 96% (95% CI, 91-99) for the LNG-IUD group, with reduced heterogeneity. The pooled pregnancy rate was 50% (95% CI, 35-65) after oral progestin and 35% (95% CI, 23-49) after LNG-IUD treatment.
CONCLUSIONS: This meta-analysis provides data on the effectiveness of oral progestins and LNG-IUD treatment within 12 months of treatment among premenopausal patients with EIN. Although based on small numbers, the rate of pregnancy after treatment is modest. These data may be beneficial for selecting progestational therapies that allow fertility preservation for patients with EIN.
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CommentIn: J Natl Cancer Inst. 2024 Mar 20;:. - PMID 38511496 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of the National Cancer Institute - (2024) vom: 01. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Suzuki, Yukio [VerfasserIn] |
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Date Revised 21.03.2024 published: Print-Electronic CommentIn: J Natl Cancer Inst. 2024 Mar 20;:. - PMID 38511496 Citation Status Publisher |
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| doi: |
10.1093/jnci/djae023 |
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| PPN (Katalog-ID): |
NLM367948583 |
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| 100 | 1 | |a Suzuki, Yukio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Levonorgestrel-releasing intrauterine device therapy versus oral progestin treatment for Reproductive-Aged patients with endometrial intraepithelial neoplasia |b a systematic review and Meta-Analysis |
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| 500 | |a CommentIn: J Natl Cancer Inst. 2024 Mar 20;:. - PMID 38511496 | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: We conducted a systematic review and meta-analysis to examine outcomes of patients with endometrial intraepithelial neoplasia (EIN) treated with oral progestins or levonorgestrel-releasing intrauterine device (LNG-IUD) | ||
| 520 | |a METHODS: We conducted a systematic review across five databases to examine outcomes of progestational treatment (oral progestins or LNG-IUD) for patients with EIN. The primary outcome was the best complete response (CR) rate within twelve months of primary progestational treatment. Sensitivity analyses were performed by removing studies with extreme effect sizes. Secondary outcomes included the pooled pregnancy rate | ||
| 520 | |a RESULTS: We identified 21 eligible studies, including 824 premenopausal patients with EIN, for our meta-analysis. Among these, 459 patients received oral progestin, while 365 patients received LNG-IUD as a primary progestational treatment. The pooled best CR proportion within 12 months was 82% (95% CI, 69-91) following oral progestin treatment, and 95% (95% CI, 81-99) following LNG-IUD treatment. After removing outlier studies, the pooled proportion was 86% (95% CI, 75-92) for the oral progestin group, and 96% (95% CI, 91-99) for the LNG-IUD group, with reduced heterogeneity. The pooled pregnancy rate was 50% (95% CI, 35-65) after oral progestin and 35% (95% CI, 23-49) after LNG-IUD treatment | ||
| 520 | |a CONCLUSIONS: This meta-analysis provides data on the effectiveness of oral progestins and LNG-IUD treatment within 12 months of treatment among premenopausal patients with EIN. Although based on small numbers, the rate of pregnancy after treatment is modest. These data may be beneficial for selecting progestational therapies that allow fertility preservation for patients with EIN | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Ferris, Jennifer S |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Ling |e verfasserin |4 aut | |
| 700 | 1 | |a Dioun, Shayan |e verfasserin |4 aut | |
| 700 | 1 | |a Usseglio, John |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuo, Koji |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Xiao |e verfasserin |4 aut | |
| 700 | 1 | |a Hershman, Dawn L |e verfasserin |4 aut | |
| 700 | 1 | |a Wright, Jason D |e verfasserin |4 aut | |
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