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 Oct;207(4):266.e1-12. doi: 10.1016/j.ajog.2012.08.011. Epub 2012 Aug 10.

Abstract

Objective: The objective of the study was to evaluate the regression, relapse, and live birth rates of early-stage endometrial cancer (EC) and atypical complex hyperplasia (ACH) with fertility-sparing treatment.

Study design: This was a metaanalysis of the proportions from observational studies with a random-effects model and a meta-regression to explore for heterogeneity.

Results: 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 2 women died.

Conclusion: Fertility-sparing treatment of EC and ACH is feasible and selected women can satisfy their reproductive wishes.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy*
  • Adult
  • Birth Rate
  • Endometrial Hyperplasia / pathology
  • Endometrial Hyperplasia / therapy*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / therapy*
  • Female
  • Fertility*
  • Humans
  • Pregnancy
  • Pregnancy Complications, Neoplastic / pathology
  • Pregnancy Complications, Neoplastic / therapy*
  • Treatment Outcome