SynthesisJournal of gynecologic oncology2023
Effects of a fertility-sparing re-treatment for recurrent atypical endometrial hyperplasia and endometrial cancer: a systematic literature review.
Synthesis in Journal of gynecologic oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Japan Society of Gynecologic Oncology 2023 guidelines for treatment of uterine body neoplasm.Journal of gynecologic oncology · 2025Guideline
- Calcium dysregulation in synergy with sonodynamic therapy via medroxyprogesterone-targeted and ROS-responsive nanoparticles for endometrial cancer.Bioactive materials · 2027Article
- The impact of previous history of malignant tumors/precancerous lesions on IVF/ICSI outcomes: a retrospective cohort study.Annals of medicine · 2026Article
- Fertility-preserving treatment of endometrial cancer and endometrial atypical hyperplasia for patients with metabolic abnormalities: Challenge or opportunity?Chinese medical journal · 2026Article
- Live Birth Outcomes After Extended or Repeated High-Dose Medroxyprogesterone Acetate Therapy for Fertility-Sparing Management of Endometrial Neoplasia: A Single-Center Retrospective Case Series.The journal of obstetrics and gynaecology research · 2026Article
- Endometrial Hyperplasia: Current Insights into Epidemiology, Risk Factors, and Clinical Management.Cancers · 2025Review
- Endometrial assessment for fertility-sparing treatment of young women with early-stage endometrial carcinoma: adaptation of a standardized synoptic reporting.Virchows Archiv : an international journal of pathology · 2025Article
- Navigating the future of fertility preservation: advanced predictive strategies for treatment outcomes of endometrial atypical hyperplasia and carcinoma.Journal of gynecologic oncology · 2025Review
- Understanding Contemporary Endometrial Cancer Survivorship Issues: Umbrella Review and Healthcare Professional Survey.Cancers · 2025Review
- Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis.Archives of gynecology and obstetrics · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the effectiveness of progestin re-treatment for recurrent endometrial intraepithelial neoplasia (EIN), atypical endometrial hyperplasia (AH) and endometrial cancer (EC) following initial fertility-sparing treatment.
methodsA comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Endometrial Cancer Committee. Multiple search engines, including PubMed/MEDLINE and the Cochrane Database, were searched in December 2021 using the keywords "Endometrial neoplasms," "Endometrial hyperplasia," "Endometrial intraepithelial neoplasia," "Fertility preservation," "Progestins," AND "Recurrence." Cases describing progestin re-treatment for recurrent EIN, AH and EC were compared with cases that underwent conventional hysterectomy. The primary outcomes were survival and disease recurrence, and the secondary outcome was pregnancy.
resultsAfter screening 238 studies, 32 with results for recurrent treatment were identified. These studies included 365 patients (270 received progestin re-treatment and 95 underwent hysterectomy). Most progestin re-treatment involved medroxyprogesterone acetate or megestrol acetate (94.5%). Complete remission (CR) following progestin re-treatment was achieved in 219 (81.1%) cases, with 3-, 6- and 9-month cumulative CR rates of 22.8%, 51.7% and 82.6%, respectively. Progestin re-treatment was associated with higher risk of disease recurrence than conventional hysterectomy was (odds ratio [OR]=6.78; 95% confidence interval [CI]=1.99-23.10), and one patient (0.4%) died of disease. Fifty-one (14.0%) women became pregnant after recurrence, and progestin re-treatment demonstrated a possibility of pregnancy (OR=2.48; 95% CI=0.94-6.58).
conclusionThis meta-analysis suggests that repeat progestin therapy is an effective option for women with recurrent EIN, AH and EC, who wish to retain their fertility.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.