Evidence mapPaperPMID 36143933Full record

ReviewMedicina (Kaunas, Lithuania)2022

Conservative Management of Atypical Endometrial Hyperplasia and Early Endometrial Cancer in Childbearing Age Women.

Stefano Uccella, Pier Carlo Zorzato, Susan Dababou, Mariachiara Bosco, Marco Torella, Andrea Braga, Matteo Frigerio, Barbara Gardella, Stefano Cianci, Antonio Simone Laganà and 2 more

Open access · goldAbstract readReview
In one paragraph

Review in Medicina (Kaunas, Lithuania), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 28 citations in OpenAlex.

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  20. Case report: A successful live birth afterFrontiers in oncology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Stefano UccellaDepartment of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy.ORCID 0000-0002-4456-0822
Pier Carlo ZorzatoDepartment of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy.
Susan DababouDepartment of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy.ORCID 0000-0002-7922-9486
Mariachiara BoscoDepartment of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy.
Marco TorellaObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Andrea BragaDepartment of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, 6850 Mendrisio, Switzerland.ORCID 0000-0002-4877-0640
Matteo FrigerioGynecology Department, San Gerardo Hospital, Milano Bicocca University, ASST Monza, 20900 Monza, Italy.ORCID 0000-0003-3952-8462
Barbara GardellaDepartment of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Stefano CianciUnit of Gynecology and Obstetrics, Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, 98121 Messina, Italy.
Antonio Simone LaganàUnit of Gynecologic Oncology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), ARNAS "Civico-Di Cristina-Benfratelli" Hospital, University of Palermo, 90127 Palermo, Italy.ORCID 0000-0003-1543-2802
Massimo Piergiuseppe FranchiDepartment of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy.
Simone GarzonDepartment of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy.ORCID 0000-0002-5840-699X
University of Verona · ITOspedale Regionale di Mendrisio · CHPoliclinico San Matteo Fondazione · ITUniversity of Campania "Luigi Vanvitelli" · ITUniversity of Messina · ITUniversity of Milano-Bicocca · ITUniversity of Palermo · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Total hysterectomy and bilateral adnexectomy is the standard treatment for atypical endometrial hyperplasia and early-stage endometrial cancer. However, the recommended surgical treatment precludes future pregnancy when these conditions are diagnosed in women in their fertile age. In these patients, fertility-sparing treatment may be feasible if the desire for childbearing is consistent and specific conditions are present. This review summarizes the available evidence on fertility-sparing management for atypical endometrial hyperplasia and early-stage endometrial cancer. Historically, oral progestins have been the mainstay of conservative management for atypical endometrial hyperplasia and stage IA endometrioid endometrial cancer with no myometrial invasion, although there is no consensus on dosage and treatment length. Intrauterine progestin therapy has proved a valid alternative option when oral progestins are not tolerated. GnRH analogs, metformin, and hysteroscopic resection in combination with progestins appear to increase the overall efficacy of the treatment. After a complete response, conception is recommended; alternatively, maintenance therapy with strict follow-up has been proposed to decrease recurrence. The risk of disease progression is not negligible, and clinicians should not overlook the risk of hereditary forms of the disease in young patients, in particular, Lynch syndrome. Hysterectomy is performed once the desire for childbearing desire has been established. The conservative management of atypical endometrial hyperplasia and early-stage endometrial cancer is feasible, provided a strong desire for childbearing and permitting clinical-pathological conditions. However, patients must be aware of the need for a strict follow-up and the risk of progression with a possible consequent worsening of the prognosis. More homogenous and well-designed studies are necessary to standardize and identify the best treatment and follow-up protocols.

Indexed as

Endometrial HyperplasiaEndometrial NeoplasmsFertility PreservationMetforminConservative TreatmentFemaleGonadotropin-Releasing HormoneHumansPregnancyProgestinsRetrospective StudiesTreatment OutcomeGonadotropin-Releasing HormoneMetforminProgestinsconservative treatmentendometrial atypical hyperplasiaendometrial cancerfertility-sparing treatment

Identifiers

PMID36143933
PMCPMC9504942
OpenAlexW4295850090

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.