Histological Prognostic Factors of Endometrial Cancer in Patients with Adenomyosis: A Systematic Review and Meta-Analysis.

Antonio Raffone, Antonio Travaglino, Diego Raimondo, Manuela Maletta, Paolo Salucci, Angela Santoro, Fulvio Zullo, Gian Franco Zannoni, Paolo Casadio, Renato Seracchioli, Antonio Mollo
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引用次数: 3

Abstract

Background: A better endometrial cancer (EC) prognosis in patients with coexistent adenomyosis has been hypothesized based on a different prevalence of favorable EC histological prognostic factors. However, pooled risk of EC unfavorable histological prognostic factors in patients with adenomyosis has never been calculated.

Objectives: We aimed to assess the risk of EC unfavorable histological prognostic factors in patients with adenomyosis.

Methods: All studies with data about histological prognostic factors of EC in patients with and without adenomyosis were included. Relative risk for each unfavorable histological prognostic factor of EC, such as nonendometrioid histotype, FIGO grade 3, FIGO stage II-IV, lymphovascular space invasion (LVSI), and deep myometrial invasion, was calculated in patients with adenomyosis compared to patients without adenomyosis.

Results: Seven studies with 4,439 patients were included in the quantitative analysis. EC patients with adenomyosis showed a pooled RR of 0.77 (p = 0.05) for nonendometrioid histotype, 0.55 (p < 0.00001) for FIGO grade 3, 0.60 (p = 0.005) for FIGO stage II-IV, 0.75 (p = 0.004) for LVSI, and 0.65 (p = 0.001) for deep myometrial invasion.

Conclusion: EC patients with adenomyosis have a significantly decreased risk for unfavorable histological prognostic factors of EC compared to EC patients without adenomyosis. Such findings might explain the supposed better EC prognosis in patients with adenomyosis.

子宫腺肌病患者子宫内膜癌的组织学预后因素:系统回顾和荟萃分析。
背景:基于有利的子宫内膜癌组织学预后因素的不同患病率,共存子宫内膜癌(EC)患者预后较好。然而,从未计算过子宫腺肌症患者EC不利组织学预后因素的总风险。目的:我们旨在评估子宫腺肌症患者发生EC的不利组织学预后因素的风险。方法:纳入所有伴有和不伴有子宫腺肌症的EC患者组织学预后因素的研究。计算腺肌病患者与非腺肌病患者的各不利组织学预后因素的相对风险,如非子宫内膜样组织型、FIGO 3级、FIGO II-IV期、淋巴血管间隙浸润(LVSI)和深部子宫肌层浸润。结果:7项研究共4439例患者被纳入定量分析。合并子宫腺肌病的EC患者,非子宫内膜样组织型的总RR为0.77 (p = 0.05), FIGO 3级的总RR为0.55 (p < 0.00001), FIGO II-IV期的总RR为0.60 (p = 0.005), LVSI的总RR为0.75 (p = 0.004),深肌层浸润的总RR为0.65 (p = 0.001)。结论:与无子宫腺肌症的EC患者相比,伴有子宫腺肌症的EC患者预后不良组织学因素的风险明显降低。这些发现可能解释了子宫腺肌病患者的EC预后较好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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