总结非肌浸润性高级别（以前为 IA 期，现在为 IC 期）子宫内膜癌患者的实践模式和结果。我们从一开始就使用 MEDLINE、Embase、Cochrane、Web of Science 和 ClinicalTrials.gov 数据库进行了系统搜索至 2024 年 5 月 8 日，以确定报告非肌浸润性高级别子宫内膜癌的治疗和结果的研究。我们纳入了接受辅助治疗或监测息肉或子宫内膜局限性高级别子宫内膜癌且无子宫肌层浸润的患者的英文全文报告，其中包含复发或生存结果的数据。两名评审员独立筛选研究；第三位审稿人解决了分歧。使用标准化表格提取数据。主要结局是复发风险。使用随机效应荟萃分析来总结二项式比例并比较辅助治疗策略的结果。总共纳入 29 项研究，代表 2770 名独特患者。总体而言，49.0% 的患者通过观察进行治疗，37.9% 的患者通过化疗进行治疗。大多数患者 (92.5%) 具有浆液性组织学特征。在 23 项有复发数据的研究中，13.7% 的患者复发，荟萃分析估计复发风险为 11%（95% 置信区间 [CI]：8-15%）。在报告接受化疗与未接受化疗的复发情况的 13 项研究中，比较荟萃分析显示复发的可能性相似（8.0% 与 13.2%；比值比 0.73，95% CI：0.38-1.42）。 (1) 辅助治疗与观察治疗以及 (2) 观察或阴道近距离放射治疗与化疗和/或外放射治疗的比较荟萃分析表明，复发风险没有统计学上的显着差异。敏感性分析结果，包括仅限于浆液组织学患者研究（12 项研究）或完整手术分期（10 项研究）的结果，总体上与主要分析一致。生存数据报告不一致，不适合荟萃分析。在非肌浸润性高级别子宫内膜癌患者中，复发风险为 11%，辅助治疗的使用与复发风险降低无关。有必要对该人群进行前瞻性研究。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To summarize practice patterns and outcomes among patients with non-myoinvasive high-grade (formerly stage IA, now stage IC) endometrial cancer.We conducted a systematic search using MEDLINE, Embase, Cochrane, Web of Science, and ClinicalTrials.gov databases from inception to May 8, 2024 to identify studies reporting on treatment and outcomes of non-myoinvasive high-grade endometrial cancer. We included full-text English reports of patients undergoing adjuvant therapy or surveillance for polyp- or endometrium-confined high-grade endometrial cancer without myometrial invasion containing data on recurrence or survival outcomes. Two reviewers independently screened studies; a third reviewer resolved disagreements. Data were extracted using a standardized form. The primary outcome was recurrence risk. Random-effects meta-analysis was used to summarize binomial proportions and to compare outcomes by adjuvant treatment strategy.A total of 29 studies were included, representing 2770 unique patients. Overall, 49.0 % of patients were managed with observation and 37.9 % with chemotherapy. Most patients (92.5 %) had serous histology. Of 23 studies with data on recurrence, 13.7 % of patients recurred, with a meta-analysis estimate recurrence risk of 11 % (95 % confidence interval [CI]: 8-15 %). Across 13 studies reporting on recurrence by receipt of chemotherapy versus no chemotherapy, comparative meta-analysis showed similar likelihood of recurrence (8.0 % versus 13.2 %; odds ratio 0.73, 95 % CI: 0.38-1.42). Comparative meta-analyses for (1) adjuvant therapy versus observation and (2) observation or vaginal brachytherapy versus chemotherapy and/or external beam radiation therapy demonstrated no statistically significant difference in recurrence risk. Sensitivity analyses results, including those limiting to studies of patients with serous histology (12 studies) or complete surgical staging (10 studies), were overall consistent with the primary analysis. Survival data was inconsistently reported and not amenable to meta-analysis.Among patients with non-myoinvasive high-grade endometrial cancer, recurrence risk was 11 % and use of adjuvant therapy was not associated with reduced recurrence risk. Prospective study of this population is warranted.Copyright © 2024 Elsevier Inc. All rights reserved.