Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, 90127 Palermo, Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
Biomolecules. 2024 Mar 5;14(3):306. doi: 10.3390/biom14030306.
Endometrial cancer (EC) is the most common gynecological malignancy in both Europe and the USA. Approximately 3-5% of cases occur in women of reproductive age. Fertility-sparing treatment (FST) options are available, but very limited evidence regarding grade 2 (G2) ECs exists in the current literature. This systematic review aimed to comprehensively evaluate reproductive and oncologic outcomes among young women diagnosed with stage IA or G2EC disease who underwent FST.
A comprehensive search of the literature was carried out on the following databases: MEDLINE, EMBASE, Global Health, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), the Health Technology Assessment Database, and Web of Science. Only original studies that reported the oncologic and reproductive outcomes of patients with stage IA and G2EC tumors who underwent FST were considered eligible for inclusion in this systematic review (CRD42023484892). Studies describing only the FST for endometrial hyperplasia or G1 EC were excluded.
Twenty-two papers that met the abovementioned inclusion criteria were included in the present systematic review. Preliminary analysis suggested encouraging oncologic and reproductive outcomes after FST.
The FST approach may represent a feasible and safe option for women of childbearing age diagnosed with G2EC. Despite these promising findings, cautious interpretation is warranted due to inherent limitations, including heterogeneity in study designs and potential biases. Further research with standardized methodologies and larger sample sizes is imperative for obtaining more robust conclusions.
子宫内膜癌（EC）是欧洲和美国最常见的妇科恶性肿瘤。约有 3-5%的病例发生在育龄妇女中。有保留生育功能的治疗（FST）方法可供选择，但目前文献中关于 2 级（G2）EC 的证据非常有限。本系统评价旨在全面评估接受 FST 的诊断为 IA 期或 G2EC 疾病的年轻女性的生殖和肿瘤学结局。
对以下数据库进行了全面的文献检索：MEDLINE、EMBASE、全球健康、Cochrane 图书馆（Cochrane 系统评价数据库、Cochrane 对照试验中心注册、Cochrane 方法学登记）、卫生技术评估数据库和 Web of Science。只有报告接受 FST 的 IA 期和 G2EC 肿瘤患者的肿瘤学和生殖结局的原始研究才被认为符合本系统评价的纳入标准（CRD42023484892）。仅描述子宫内膜增生或 G1 EC 的 FST 的研究被排除在外。
有 22 篇符合上述纳入标准的论文被纳入本系统评价。初步分析表明，FST 后的肿瘤学和生殖结局令人鼓舞。
对于诊断为 G2EC 的育龄妇女，FST 方法可能是一种可行且安全的选择。尽管有这些有希望的发现，但由于研究设计的异质性和潜在的偏倚等固有局限性，需要谨慎解释。需要采用标准化方法和更大样本量的进一步研究，以得出更可靠的结论。
