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.

Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma: We can hope, at least / Raffone A.; Raimondo D.; Rovero G.; Travaglino A.; Lopez G.; DiMaio C.M.; Neola D.; Raspollini A.; Renzulli F.; Filippelli A.; Casadio P.; Seracchioli R.; Guida M.. - In: INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS. - ISSN 0020-7292. - ELETTRONICO. - 00:(2023), pp. 1-10. [10.1002/ijgo.15146]

Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma: We can hope, at least

Raffone A.;Raimondo D.;Rovero G.;Raspollini A.;Renzulli F.;Casadio P.;Seracchioli R.;
2023

Abstract

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.
2023
Conservative re-treatment of women with atypical endometrial hyperplasia and early endometrial carcinoma: We can hope, at least / Raffone A.; Raimondo D.; Rovero G.; Travaglino A.; Lopez G.; DiMaio C.M.; Neola D.; Raspollini A.; Renzulli F.; Filippelli A.; Casadio P.; Seracchioli R.; Guida M.. - In: INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS. - ISSN 0020-7292. - ELETTRONICO. - 00:(2023), pp. 1-10. [10.1002/ijgo.15146]
Raffone A.; Raimondo D.; Rovero G.; Travaglino A.; Lopez G.; DiMaio C.M.; Neola D.; Raspollini A.; Renzulli F.; Filippelli A.; Casadio P.; Seracchioli R.; Guida M.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/949445
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