Abstract:
In association with an update of the Japan Society of Gynecologic Oncology clinical practice guidelines for endometrial cancer in 2023, a systematic review was conducted about the therapeutic benefit of adjuvant therapy on patients with early-stage endometrial carcinoma, who presented positive peritoneal cytology (PPC) without the risk factors for recurrence. The systematic review only included two eligible retrospective studies. Both studies included patients with risk factors for recurrence. A nationwide study in the United States reported that adjuvant chemotherapy was associated with the reduced risk of death among patients with stages I-II endometrial cancer with PPC by multivariate, propensity score-adjusted analysis. Another single-center study in Japan reported no association between adjuvant chemotherapy and relapse-free survival among patients with stage IA endometrial cancer by univariate analysis. This systematic review identified that evidence was limited with conflicting results. Continuous evaluation is warranted to address this clinical question.
摘要:
结合2023年日本妇科肿瘤学会子宫内膜癌临床实践指南的更新,对早期子宫内膜癌患者辅助治疗的治疗益处进行了系统评价。腹膜细胞学(PPC)阳性,没有复发的危险因素。系统评价仅包括两项符合条件的回顾性研究。两项研究都包括有复发危险因素的患者。美国的一项全国性研究报道,通过多变量分析,辅助化疗与I-II期PPC子宫内膜癌患者死亡风险降低相关。倾向得分调整分析。日本的另一项单中心研究报告,单变量分析显示IA期子宫内膜癌患者的辅助化疗与无复发生存期之间没有关联。这项系统评价发现,证据有限,结果相互矛盾。需要持续的评估来解决这个临床问题。