Meta-analysis Of Progesterone Treatment Of Young Patients With Early Stage Endometrial Cancer

Background: Endometrial carcinoma is a common malignancy of the femalereproductive system，the incidence of endometrial cancer tended to increase in recentyears, the incidence is growing rapidly in young patients. Traditional treatment ofendometrial carcinoma is hysterectomy and double oophorectomy, if necessary, requireabdominal lymphadenectomy. This makes the patient completely lost reproductivefunction. However, many young patients have not fertility yet, these patients oftenstrongly urged to retain reproductive function. In recent years, the role of progesteronetherapy has been affirmed in younger patients with early stage. But for progesteronetherapy safety, efficacy and other issues did not reach a consensus.Objective: Using meta-analysis methods for progesterone treatment safety, efficacy,pregnancy timing after fertility treatment and other issues for an analysis. Expectationsof endometrial cancer to preserve fertility treatment to provide a frame of reference.Methods: We searched the Pubmed database, Medline database, Science Directdatabase, CNKI, Chinese Biomedical Literature Database (CBM) and so on. Collect allabout young patients in early stage endometrial cancer with hormone treatment.Languages were restrieted to Chinese and English. Retrieval time is not limited. Studieswere slected according to strict inclusion and exclusion criteria.Data extraction andquality assessment was performed indenpently by the author. All the calculation andstatistical tested with the R software.(R2.13.1). Analysis of the complete remission rate,relapse rate after treatment and maternity cases.Results: Through strict inclusion and exclusion criteria, according to the retrievaland through initial screening, the final total of10articles were selected,391patientswere enrolled, extract data for statistical analysis. The results showed: the total complete remission rate was57.07%，CI [0.5111;0.6282], the total recurrence rate was35.37%，CI [0.2786;0.4367], the total pregnancy rate (number) was36.19%，CI[0.3046;0.4234], the total birth rate was34.22%，CI [0.2819;0.4081]. From all theliterature，extracted6Literature of complete information, collected patientsinformation of relapse after complete remission and after treatment ineffectiveundergoing surgery, analysis disease outcomes after progesterone treatment, the resultsshowed: The median follow-up of39.5months,34patients underwent surgery,5.88%(2/34) disease progression,97.06%(33/34) of patients with tumor-free survival, only2.94%(1/34) postoperative recurrence.Conclusion:1.The total complete remission rate of young patients in early stage endometrialcancer with hormone treatment was57.07%, the total recurrence rate was35.37%,thepatients of ineffective treatment and relapse after complete remission receivedcomprehensive surgical staging. There is no difference in the prognosis of patientsundergoing surgery directly.Description progestin therapy is safe.2. he results showed that the total pregnancy rate (number) was36.19%, the totalbirth rate was34.22%,.Progestin therapy showed high success rate, the method isfeasible.3. Positive application of assisted reproductive technology is expected to improvepregnancy and birth rates upon completion of progestin therapy.4. Conservative surgery (such as hysteroscopy) combined progestin therapycompared with the simple application of progesterone treatment is safe, have a highpregnancy rate.5. We recommend hysterectomy immediately after the completion of childbearing,or need close follow-up.