Fertility-Sparing Treatment of Women With Endometrial Carcinoma With Myometrial Invasion: Pooled Estimates of Response From a Systematic Review and Meta-Analysis.
Antonio Raffone, Daniele Neola, Francesco Viciglione et al.
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In 30 seconds
This systematic review and meta-analysis pooled outcomes of fertility-sparing conservative treatment for endometrial carcinoma with myometrial invasion. It included three retrospective observational cohort studies involving 39 women with invasion <50%. The pooled complete response rate was 82% (95% CI: 66%-94%), while recurrence was 37% (95% CI: 11%-66%). The authors noted that recurrence was slightly higher than reported for endometrial carcinoma without myometrial invasion. They concluded that this approach is not currently standard care and merits prospective evaluation in carefully selected patients receiving intensive surveillance.
Key findings
- Pooled complete response was 82% (95% CI: 66%-94%) among women with myometrial invasion <50%.
- Pooled recurrence was 37% (95% CI: 11%-66%), slightly higher than reported for disease without myometrial invasion.
- Pooled rates were 3% (95% CI: 0%-14%) for partial response, 13% (95% CI: 3%-27%) for stable disease, and 0% (95% CI: 0%-4%) for progressive disease.
Why it matters
These pooled estimates describe response and recurrence after fertility-sparing treatment in a group for whom evidence is limited. The substantial recurrence estimate is relevant when weighing conservative management and underscores the importance of careful selection and surveillance. The findings provide a basis for prospective evaluation but do not establish comparative effectiveness or routine suitability.
What to keep in mind
Evidence came from only three retrospective observational cohorts, comprising 39 women; the pooled estimates therefore rest on a small, nonrandomised evidence base.