Evidence map›Paper›PMID 38305500›Full record

SynthesisJournal of the National Cancer Institute2024

Levonorgestrel-releasing intrauterine device therapy vs oral progestin treatment for reproductive-aged patients with endometrial intraepithelial neoplasia: a systematic review and meta-analysis.

Yukio Suzuki, Jennifer S Ferris, Ling Chen, Shayan Dioun, John Usseglio, Koji Matsuo, Xiao Xu, Dawn L Hershman, Jason D Wright

Open access · greenAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the National Cancer Institute, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
7.0field-weighted citation impact, top 3% 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

4 citing papers in PubMed, 12 citations in OpenAlex.

  1. Updates and evolving care paradigms for pre-menopausal patients with endometrial cancer.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2026
    Review
  2. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Yukio SuzukiColumbia University College of Physicians and Surgeons, New York, NY, USA.
Jennifer S FerrisColumbia University College of Physicians and Surgeons, New York, NY, USA.
Ling ChenColumbia University College of Physicians and Surgeons, New York, NY, USA.
Shayan DiounColumbia University College of Physicians and Surgeons, New York, NY, USA.
John UsseglioAugustus C. Long Health Sciences Library, Columbia University Irving Medical Center, New York, NY, USA.
Koji MatsuoUniversity of Southern California, Los Angeles, CA, USA.
Xiao XuColumbia University College of Physicians and Surgeons, New York, NY, USA.
Dawn L HershmanColumbia University College of Physicians and Surgeons, New York, NY, USA.
Jason D WrightColumbia University College of Physicians and Surgeons, New York, NY, USA.ORCID 0000-0001-6390-825X
Columbia University · USNewYork–Presbyterian Hospital · USColumbia University Irving Medical Center · USUniversity of Southern California · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe conducted a systematic review and meta-analysis to examine outcomes of patients with endometrial intraepithelial neoplasia treated with oral progestins or a levonorgestrel-releasing intrauterine device (IUD).

methodsWe conducted a systematic review across 5 databases to examine outcomes of progestational treatment (oral progestins or levonorgestrel-releasing IUD) for patients with endometrial intraepithelial neoplasia. The primary outcome was the best complete response rate within 12 months of primary progestational treatment. Sensitivity analyses were performed by removing studies with extreme effect sizes. Secondary outcomes included the pooled pregnancy rate.

resultsWe identified 21 eligible studies, including 824 premenopausal patients with endometrial intraepithelial neoplasia, for our meta-analysis. Among these, 459 patients received oral progestin, and 365 patients received levonorgestrel-releasing IUD as a primary progestational treatment. The pooled best complete response proportion within 12 months was 82% (95% confidence interval [CI] = 69% to 91%) following oral progestin treatment and 95% (95% CI = 81% to 99%) following levonorgestrel-releasing IUD treatment. After removing outlier studies, the pooled proportion was 86% (95% CI = 75% to 92%) for the oral progestin group and 96% (95% CI = 91% to 99%) for the levonorgestrel-releasing IUD group, with reduced heterogeneity. The pooled pregnancy rate was 50% (95% CI = 35% to 65%) after oral progestin and 35% (95% CI = 23% to 49%) after levonorgestrel-releasing IUD treatment.

conclusionsThis meta-analysis provides data on the effectiveness of oral progestins and levonorgestrel-releasing IUD treatment within 12 months of treatment among premenopausal patients with endometrial intraepithelial neoplasia. Although based on small numbers, the rate of pregnancy after treatment is modest. These data may be beneficial for selecting progestational therapies that allow fertility preservation for patients with endometrial intraepithelial neoplasia.

Indexed as

Endometrial NeoplasmsIntrauterine Devices, MedicatedLevonorgestrelPregnancy RateProgestinsAdministration, OralAdultCarcinoma in SituFemaleHumansPregnancyTreatment OutcomeLevonorgestrelProgestins

Identifiers

PMID38305500
PMCPMC11491835
OpenAlexW4391465051

What Socratic holds

Textmetadata
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.