American Journal of Obstetrics and Gynecology
ResearchGeneral gynecologyRegression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis
Section snippets
Identification of literature
The population of interest in this systematic review was women with early clinical stage (International Federation of Gynecology and Obstetrics stage I) EC or ACH, the intervention was fertility-sparing therapies, and the outcome was evidence of disease regression, relapse, and live births. The following electronic databases were searched: MEDLINE (1950 to September 2011), EMBASE (1980 to September 2011), Cochrane Central Register of Controlled Trials and Web of Science conference proceedings
Selection, characteristics and quality of the primary studies
The electronic search strategy yielded 9516 citations, and we retrieved a further 10 citations from our manual checking of reference lists of all primary articles. Of these, 9477 citations were excluded because they did not fulfill the selection criteria. Examination of the full text of the remaining 54 manuscripts found a total of 34 primary studies,12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45 including
Comment
This metaanalysis, which included 408 women with EC and 151 with ACH, found that the regression rates with fertility-sparing treatment are very encouraging (76% for EC and 86% for ACH). An additional encouraging proportion of women choosing this treatment for preserving their fertility managed to achieve live births (28% of women with EC and 26% of women with ACH). Women choosing assisted reproductive treatment had significantly better results, regardless of the initial diagnosis. However, the
Acknowledgment
We thank Wilma Arnold for her administrative support.
References (48)
- et al.
Oral progestogens vs levonorgestrel-releasing intrauterine system for endometrial hyperplasia: a systematic review and metaanalysis
Am J Obstet Gynecol
(2010) - et al.
Current management of endometrial hyperplasia—a survey of United Kingdom consultant gynaecologists
Eur J Obstet Gynecol Reprod Biol
(2011) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Can primary endometrial carcinoma stage I be cured without surgery and radiation therapy?
Gynecol Oncol
(1985) - et al.
Endometrial cancer in women 40 years old or younger
Gynecol Oncol
(2001) - et al.
Outcome of in vitro fertilization treatment in infertile women conservatively treated for endometrial adenocarcinoma
Fertil Steril
(2007) - et al.
Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer
Obstet Gynecol
(2003) - et al.
Conservative treatment may be beneficial for young women with atypical endometrial hyperplasia or endometrial adenocarcinoma
Fertil Steril
(2003) - et al.
Conservative therapy for adenocarcinoma and atypical endometrial hyperplasia of the endometrium in young women: central pathologic review and treatment outcome
Cancer Lett
(2001) - et al.
Conservative treatment of early endometrial cancer: preliminary results of a pilot study
Gynecol Oncol
(2011)
[Young women with atypical endometrial hyperplasia or endometrial adenocarcinoma stage I: will conservative treatment allow pregnancy? Results of a French multicentric survey]
Gynecol Obstet Fertil
Letrozole as primary therapy for endometrial hyperplasia in young women
Int J Gynaecol Obstet
Outcomes of conservative therapy for young women with early endometrial adenocarcinoma
Fertil Steril
Conservative surgical management of stage IA endometrial carcinoma for fertility preservation
Fertil Steril
Combined phospho-Akt and PTEN expressions associated with post-treatment hysterectomy after conservative progestin therapy in complex atypical hyperplasia and stage Ia, G1 adenocarcinoma of the endometrium
Cancer Lett
Progestin intrauterine device and GnRH analogue for uterus-sparing treatment of endometrial precancers and well-differentiated early endometrial carcinoma in young women
Ann Oncol
Intrauterine progesterone treatment of early endometrial cancer
Am J Obstet Gynecol
Progestin treatment of atypical hyperplasia and well-differentiated carcinoma of the endometrium in women under age 40
Obstet Gynecol
Reevaluating the safety of fertility-sparing hormonal therapy for early endometrial cancer
Gynecol Oncol
Sparing fertility in young patients with endometrial cancer
Gynecol Oncol
Cancer Statistics registrations: registrations of cancer diagnosed in 2007, EnglandNational Statistics (Series MB1 no. 38)
Infertility-associated endometrial cancer risk may be limited to specific subgroups of infertile women
Obstet Gynecol
Classification of endometrial hyperplasia
Methodological index for non-randomized studies (minors): development and validation of a new instrument
ANZ J Surg
Cited by (280)
Prediction of complete regression in fertility-sparing patients with endometrial cancer and apical hyperplasia: the GLOBAL model in a large Chinese cohort
2024, Journal of Translational MedicineMetformin and progestins in women with atypical hyperplasia or endometrial cancer: systematic review and meta-analysis
2024, Archives of Gynecology and ObstetricsA Case Report of Consecutive Live Birth Twice Through in vitro Fertilization and Embryo Transfer After Endometrial Carcinoma Fertility Preservation Treatment
2024, International Journal of Women's HealthFertility-sparing treatment in cancer patients: how can we help in the 21st century?
2024, Russian Journal of Human Reproduction
This study and I.D.G. were supported through a Wellbeing of Women entry-level scholarship (ELS022).
The authors report no conflict of interest.
Cite this article as: Gallos ID, Yap J, Rajkhowa M, et al. Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis. Am J Obstet Gynecol 2012;207;266.e1-12.