The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis
Introduction The number of patients desiring fertility-preserving treatment for endometrial cancer rather than standard surgical management continues to increase.Objective We aimed to evaluate the efficacies of fertility-preserving treatments on the live birth rate, remission and relapse rates for w...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Obstetrics and Gynaecology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/01443615.2023.2294329 |
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| author | M. Olabisi Ogunbiyi Samuel Oxley Radha Graham Adeola Olaitan |
| author_facet | M. Olabisi Ogunbiyi Samuel Oxley Radha Graham Adeola Olaitan |
| author_sort | M. Olabisi Ogunbiyi |
| collection | DOAJ |
| description | Introduction The number of patients desiring fertility-preserving treatment for endometrial cancer rather than standard surgical management continues to increase.Objective We aimed to evaluate the efficacies of fertility-preserving treatments on the live birth rate, remission and relapse rates for women with stage 1a grade 1 endometrial carcinoma to support patient counselling.Methods We performed a meta-analysis for our primary outcomes of overall remission and relapse rate, and for secondary analysis, we divided papers into treatment type: systemic progestins, intrauterine progestins or hysteroscopic resection and adjuvant hormonal treatment.Results Thirty-five observational studies met inclusion criteria, with a total of 624 patients. Overall, conservative treatment of endometrial cancer showed a remission rate of 77% (95% CI: 70–84%), a relapse rate of 20% (95% CI: 13–27%) and a live birth rate of 20% (95% CI: 15–25%) with more favourable outcomes for the hysteroscopic resection group.Conclusions Hysteroscopic resection and adjuvant hormonal treatment had the most favourable fertility and oncological outcomes. Further high-quality prospective multi-centre trials are warranted to determine the optimal treatment regimen and dosage and risk stratification for these patients. |
| format | Article |
| id | doaj-art-5ea895430d4f4f8887d26a3bee1186f4 |
| institution | Kabale University |
| issn | 0144-3615 1364-6893 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Obstetrics and Gynaecology |
| spelling | doaj-art-5ea895430d4f4f8887d26a3bee1186f42025-01-09T12:13:17ZengTaylor & Francis GroupJournal of Obstetrics and Gynaecology0144-36151364-68932024-12-0144110.1080/01443615.2023.2294329The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysisM. Olabisi Ogunbiyi0Samuel Oxley1Radha Graham2Adeola Olaitan3University College London Hospitals NHS Foundation Trust, London, UKUniversity College London Hospitals NHS Foundation Trust, London, UKUniversity College London Hospitals NHS Foundation Trust, London, UKUniversity College London Hospitals NHS Foundation Trust, London, UKIntroduction The number of patients desiring fertility-preserving treatment for endometrial cancer rather than standard surgical management continues to increase.Objective We aimed to evaluate the efficacies of fertility-preserving treatments on the live birth rate, remission and relapse rates for women with stage 1a grade 1 endometrial carcinoma to support patient counselling.Methods We performed a meta-analysis for our primary outcomes of overall remission and relapse rate, and for secondary analysis, we divided papers into treatment type: systemic progestins, intrauterine progestins or hysteroscopic resection and adjuvant hormonal treatment.Results Thirty-five observational studies met inclusion criteria, with a total of 624 patients. Overall, conservative treatment of endometrial cancer showed a remission rate of 77% (95% CI: 70–84%), a relapse rate of 20% (95% CI: 13–27%) and a live birth rate of 20% (95% CI: 15–25%) with more favourable outcomes for the hysteroscopic resection group.Conclusions Hysteroscopic resection and adjuvant hormonal treatment had the most favourable fertility and oncological outcomes. Further high-quality prospective multi-centre trials are warranted to determine the optimal treatment regimen and dosage and risk stratification for these patients.https://www.tandfonline.com/doi/10.1080/01443615.2023.2294329Endometrial cancerfertility preservingprogesteronehysteroscopic resection |
| spellingShingle | M. Olabisi Ogunbiyi Samuel Oxley Radha Graham Adeola Olaitan The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis Journal of Obstetrics and Gynaecology Endometrial cancer fertility preserving progesterone hysteroscopic resection |
| title | The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis |
| title_full | The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis |
| title_fullStr | The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis |
| title_full_unstemmed | The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis |
| title_short | The oncological and reproductive outcomes of fertility-preserving treatments for stage 1 grade 1 endometrial carcinoma: a systematic review and meta-analysis |
| title_sort | oncological and reproductive outcomes of fertility preserving treatments for stage 1 grade 1 endometrial carcinoma a systematic review and meta analysis |
| topic | Endometrial cancer fertility preserving progesterone hysteroscopic resection |
| url | https://www.tandfonline.com/doi/10.1080/01443615.2023.2294329 |
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