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Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis

, : Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis. American Journal of Obstetrics and Gynecology 207(4): 266.E1-12

To evaluate the regression, relapse and live birth rates of early-stage endometrial cancer (EC) and atypical complex hyperplasia (ACH) with fertility-sparing treatment. Meta-analysis of proportions from observational studies with random effects model and meta-regression to explore for heterogeneity. Thirty-four observational studies, evaluating the regression, relapse and live birth rates of early-stage EC (408 women) and ACH (151 women) with fertility-sparing treatment. Fertility-sparing treatment for EC achieved a pooled regression rate of 76.2%, a relapse rate of 40.6% and a live birth rate of 28%. For ACH the pooled regression rate was 85.6%, a relapse rate of 26% and a live birth rate of 26.3%. Twenty women were diagnosed with ovarian cancer (concurrent or metastatic) during follow-up (3.6%) and 10 progressed to higher than stage I EC (1.9%) from which two women died. Fertility-sparing treatment of EC and ACH is feasible and selected women can satisfy their reproductive wishes.


PMID: 23021687

DOI: 10.1016/j.ajog.2012.08.011

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