Ronsini Carlo, Reino Antonella, Molitierno Rossella, Vastarella Maria Giovanna, La Mantia Elvira, De Franciscis Pasquale
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Largo Madonna Delle Grazie, 1, 80138 Naples, Italy.
Pathology Unit, University of Campania "L. Vanvitelli", Via Luciano Armanni, 80138 Naples, Italy.
Life (Basel). 2023 Jun 22;13(7):1429. doi: 10.3390/life13071429.
SEIC is a non-invasive lesion of the endometrial epithelium considered to be the precursor to uterine serous carcinoma (USC) and is just as aggressive as USC. Currently, there are no reliable data about the behavior and prognosis of SEIC; therefore, the therapeutic management approach is not clear. : A systematic search of the Pubmed, Scopus and Embase databases was conducted, following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). : Of the 296 studies that matched the search criteria, only 9 met the inclusion criteria, covering a total of 81 patients. The main disease-presenting pattern was AUB (abnormal uterine bleeding). In 31 cases, SEIC was associated with extrauterine disease. All patients underwent hysterectomy and salpingo-oophorectomy, while only 15 of the 81 patients received adjuvant treatments. In the patients receiving adjuvant therapy, the RR was 42.67%, the DFS was 35.71% and the OS was 57.13%. In patients subjected to follow-up alone, the RR was only 28.78%, the DFS was 59.1% and the OS was 66.6%. : The presence of an extrauterine disease significantly worsens outcomes, regardless of adjuvant treatment. In cases of disease confined to the uterine mucosa alone, the prognosis is good and follow-up allows a good control of the disease; however, adjuvant therapy could further increase survival rates and reduce relapse rates.
子宫内膜上皮内癌(SEIC)是一种非侵入性病变,被认为是子宫浆液性癌(USC)的前驱病变,其侵袭性与USC相同。目前,关于SEIC的行为和预后尚无可靠数据;因此,治疗管理方法尚不清楚。:按照系统评价和Meta分析的首选报告项目(PRISMA)中的建议,对PubMed、Scopus和Embase数据库进行了系统检索。:在符合检索标准的296项研究中,只有9项符合纳入标准,共涉及81例患者。主要疾病表现模式为异常子宫出血(AUB)。在31例病例中,SEIC与子宫外疾病相关。所有患者均接受了子宫切除术和输卵管卵巢切除术,而81例患者中只有15例接受了辅助治疗。在接受辅助治疗的患者中,复发率(RR)为42.67%,无病生存率(DFS)为35.71%,总生存率(OS)为57.13%。在仅接受随访的患者中,RR仅为28.78%,DFS为59.1%,OS为66.6%。:无论是否接受辅助治疗,子宫外疾病的存在都会显著恶化预后。在仅局限于子宫黏膜的疾病病例中,预后良好,随访可实现对疾病的良好控制;然而,辅助治疗可进一步提高生存率并降低复发率。