Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis
Objective Levonorgestrel intrauterine system (LNG-IUS) has been widely used in patients with endometrial carcinoma (EC), endometrial hyperplasia without atypical (EH), and atypical endometrial hyperplasia (AEH). The purpose of our Network meta-analysis (NMA) is to evaluate the efficacy of the treatm...
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| Veröffentlicht in: | Archives of gynecology and obstetrics 2024-09, Vol.310 (3), p.1315-1329 |
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| creator | Tao, Muheng Wu, Tingting Zhou, Xin Du, Xiurong Ling, Kaijian Liang, Zhiqing |
| description | Objective
Levonorgestrel intrauterine system (LNG-IUS) has been widely used in patients with endometrial carcinoma (EC), endometrial hyperplasia without atypical (EH), and atypical endometrial hyperplasia (AEH). The purpose of our Network meta-analysis (NMA) is to evaluate the efficacy of the treatments based on the LNG-IUS in patients with EC and EH with or without atypical.
Methods
We examined PubMed, EMBASE, Web of Science and the Cochrane Library up to 22 April 2024 to determine studies reporting treatment outcomes in EC and EH patients receiving LNG-IUS therapy, LNG-IUS + metformin (MET), oral progestins (OP), etc. We used EndNote 9 to select studies, Jadad scale and NOS scale to assess quality, stata(16.0) and R (4.3.1) to analysis the data.
Results
Overall, 28 studies involving 3752 patients were included in our NMA. As for EH patients, LNG-IUS (RR 1.21; 95% CrI [1.11, 1.34]) and LNG-IUS + MET (RR 323.57; 95% CrI [1.61, 214,223,188.1])] significantly increased CR rate in comparison with OP. Based on SUCRA, LNG-IUS + OP was the best treatment to improve CR(SUCRA = 67.2%) in patients with EC, whereas LNG-IUS + MET was superior in increasing CR (SUCRA = 99.8%) than any other treatments for EH patients. Besides, the ranking based on SUCRA illustrated that LNG-IUS alone was the best choice to raise CR rates (SUCRA = 76.7%) for AEH patients. In head-to-head meta-analysis, OP has a higher progression rate (RR 4, 95% CI 1.89–8.46,
p
= 0.062;
I
2
= 71.3%), a higher nausea rate (RR 1.93, 95% CI 1.24–3.01,
p
= 0.187;
I
2
= 40.4%) than LNG-IUS in patients with EH. In contrast, LNG-IUS had a irregular vaginal bleeding rates (RR 0.76, 95% CI 0.64–0.90,
p
= 0.034;
I
2
= 77.7%) than OP in EH patients. In addition, as for AEH patients, OP has a higher persistence rate (RR 4.31, 95% CI 1.43–13.00,
p
= 0.93;
I
2
= 0.0%) than LNG-IUS.
Conclusion
According to the NMA, LNG-IUS related studies are feasible for conservative therapy in patients with EC and EH with or without atypical. Therefore, concerning the curative effect, we recommend LNG-IUS-based treatments as the best conservative therapy for EC and EH patients. However, future studies require large sample sizes and more outcomes to further evaluate the differences of treatment selections based on LNG-IUS. |
| doi_str_mv | 10.1007/s00404-024-07608-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3077187864</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3099338762</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-c77623484eb08ef89114eae6c13e2729e9858da872fa3c348a14f84ba7e9ae943</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0Eou3CH-CALHHhEvBXY4cbWhWKVIkLnK1ZZ9K6JHawna72b_ELcdjyeeBgecbzzDtjvYQ84-wVZ0y_zowpphom6tEtM83-ATnlSoqacv7wj_iEnOV8yxgXxrSPyYk0nWFStafk2zZOMyQo_g4pDgO6kmkcaO9rnDAUWhJCmWqU6Q4y9jQGWm6QjngXQ0zXmCsxUh9KgqVg8gFpPuSCU32jGPo4YUkeRuogOR_iBBRC_1fl5jBjmkfIHuhcd1mnvaFAA5Z9TF9o5aCBAOMh-_yEPBpgzPj0_t6Qz-8uPm0vm6uP7z9s3141Tpy3pXFat0Iqo3DHDA6m41whYOu4RKFFh505Nz0YLQaQroLA1WDUDjR2gJ2SG_LyqDun-HWp37STzw7HEQLGJVvJtOZGm3ZFX_yD3sYl1X1XquukNOsuGyKOlEsx54SDnZOfIB0sZ3Z11B4dtdVR-8NRu69Nz--ll92E_a-WnxZWQB6BXEvhGtPv2f-R_Q5MirGR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3099338762</pqid></control><display><type>article</type><title>Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Tao, Muheng ; Wu, Tingting ; Zhou, Xin ; Du, Xiurong ; Ling, Kaijian ; Liang, Zhiqing</creator><creatorcontrib>Tao, Muheng ; Wu, Tingting ; Zhou, Xin ; Du, Xiurong ; Ling, Kaijian ; Liang, Zhiqing</creatorcontrib><description>Objective
Levonorgestrel intrauterine system (LNG-IUS) has been widely used in patients with endometrial carcinoma (EC), endometrial hyperplasia without atypical (EH), and atypical endometrial hyperplasia (AEH). The purpose of our Network meta-analysis (NMA) is to evaluate the efficacy of the treatments based on the LNG-IUS in patients with EC and EH with or without atypical.
Methods
We examined PubMed, EMBASE, Web of Science and the Cochrane Library up to 22 April 2024 to determine studies reporting treatment outcomes in EC and EH patients receiving LNG-IUS therapy, LNG-IUS + metformin (MET), oral progestins (OP), etc. We used EndNote 9 to select studies, Jadad scale and NOS scale to assess quality, stata(16.0) and R (4.3.1) to analysis the data.
Results
Overall, 28 studies involving 3752 patients were included in our NMA. As for EH patients, LNG-IUS (RR 1.21; 95% CrI [1.11, 1.34]) and LNG-IUS + MET (RR 323.57; 95% CrI [1.61, 214,223,188.1])] significantly increased CR rate in comparison with OP. Based on SUCRA, LNG-IUS + OP was the best treatment to improve CR(SUCRA = 67.2%) in patients with EC, whereas LNG-IUS + MET was superior in increasing CR (SUCRA = 99.8%) than any other treatments for EH patients. Besides, the ranking based on SUCRA illustrated that LNG-IUS alone was the best choice to raise CR rates (SUCRA = 76.7%) for AEH patients. In head-to-head meta-analysis, OP has a higher progression rate (RR 4, 95% CI 1.89–8.46,
p
= 0.062;
I
2
= 71.3%), a higher nausea rate (RR 1.93, 95% CI 1.24–3.01,
p
= 0.187;
I
2
= 40.4%) than LNG-IUS in patients with EH. In contrast, LNG-IUS had a irregular vaginal bleeding rates (RR 0.76, 95% CI 0.64–0.90,
p
= 0.034;
I
2
= 77.7%) than OP in EH patients. In addition, as for AEH patients, OP has a higher persistence rate (RR 4.31, 95% CI 1.43–13.00,
p
= 0.93;
I
2
= 0.0%) than LNG-IUS.
Conclusion
According to the NMA, LNG-IUS related studies are feasible for conservative therapy in patients with EC and EH with or without atypical. Therefore, concerning the curative effect, we recommend LNG-IUS-based treatments as the best conservative therapy for EC and EH patients. However, future studies require large sample sizes and more outcomes to further evaluate the differences of treatment selections based on LNG-IUS.</description><identifier>ISSN: 1432-0711</identifier><identifier>ISSN: 0932-0067</identifier><identifier>EISSN: 1432-0711</identifier><identifier>DOI: 10.1007/s00404-024-07608-w</identifier><identifier>PMID: 38980346</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Contraceptive Agents, Hormonal - administration & dosage ; Contraceptive Agents, Hormonal - therapeutic use ; Endocrinology ; Endometrial cancer ; Endometrial Hyperplasia - drug therapy ; Endometrial Neoplasms - drug therapy ; Endometrial Neoplasms - pathology ; Female ; Gynecology ; Human Genetics ; Humans ; Hyperplasia ; Intrauterine Devices, Medicated ; Levonorgestrel - administration & dosage ; Levonorgestrel - therapeutic use ; Medicine ; Medicine & Public Health ; Metformin - administration & dosage ; Metformin - therapeutic use ; Network Meta-Analysis ; Obstetrics/Perinatology/Midwifery ; Progestins - administration & dosage ; Progestins - therapeutic use ; Review ; Treatment Outcome</subject><ispartof>Archives of gynecology and obstetrics, 2024-09, Vol.310 (3), p.1315-1329</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-c77623484eb08ef89114eae6c13e2729e9858da872fa3c348a14f84ba7e9ae943</cites><orcidid>0009-0002-2994-3689</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00404-024-07608-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00404-024-07608-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38980346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tao, Muheng</creatorcontrib><creatorcontrib>Wu, Tingting</creatorcontrib><creatorcontrib>Zhou, Xin</creatorcontrib><creatorcontrib>Du, Xiurong</creatorcontrib><creatorcontrib>Ling, Kaijian</creatorcontrib><creatorcontrib>Liang, Zhiqing</creatorcontrib><title>Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis</title><title>Archives of gynecology and obstetrics</title><addtitle>Arch Gynecol Obstet</addtitle><addtitle>Arch Gynecol Obstet</addtitle><description>Objective
Levonorgestrel intrauterine system (LNG-IUS) has been widely used in patients with endometrial carcinoma (EC), endometrial hyperplasia without atypical (EH), and atypical endometrial hyperplasia (AEH). The purpose of our Network meta-analysis (NMA) is to evaluate the efficacy of the treatments based on the LNG-IUS in patients with EC and EH with or without atypical.
Methods
We examined PubMed, EMBASE, Web of Science and the Cochrane Library up to 22 April 2024 to determine studies reporting treatment outcomes in EC and EH patients receiving LNG-IUS therapy, LNG-IUS + metformin (MET), oral progestins (OP), etc. We used EndNote 9 to select studies, Jadad scale and NOS scale to assess quality, stata(16.0) and R (4.3.1) to analysis the data.
Results
Overall, 28 studies involving 3752 patients were included in our NMA. As for EH patients, LNG-IUS (RR 1.21; 95% CrI [1.11, 1.34]) and LNG-IUS + MET (RR 323.57; 95% CrI [1.61, 214,223,188.1])] significantly increased CR rate in comparison with OP. Based on SUCRA, LNG-IUS + OP was the best treatment to improve CR(SUCRA = 67.2%) in patients with EC, whereas LNG-IUS + MET was superior in increasing CR (SUCRA = 99.8%) than any other treatments for EH patients. Besides, the ranking based on SUCRA illustrated that LNG-IUS alone was the best choice to raise CR rates (SUCRA = 76.7%) for AEH patients. In head-to-head meta-analysis, OP has a higher progression rate (RR 4, 95% CI 1.89–8.46,
p
= 0.062;
I
2
= 71.3%), a higher nausea rate (RR 1.93, 95% CI 1.24–3.01,
p
= 0.187;
I
2
= 40.4%) than LNG-IUS in patients with EH. In contrast, LNG-IUS had a irregular vaginal bleeding rates (RR 0.76, 95% CI 0.64–0.90,
p
= 0.034;
I
2
= 77.7%) than OP in EH patients. In addition, as for AEH patients, OP has a higher persistence rate (RR 4.31, 95% CI 1.43–13.00,
p
= 0.93;
I
2
= 0.0%) than LNG-IUS.
Conclusion
According to the NMA, LNG-IUS related studies are feasible for conservative therapy in patients with EC and EH with or without atypical. Therefore, concerning the curative effect, we recommend LNG-IUS-based treatments as the best conservative therapy for EC and EH patients. However, future studies require large sample sizes and more outcomes to further evaluate the differences of treatment selections based on LNG-IUS.</description><subject>Contraceptive Agents, Hormonal - administration & dosage</subject><subject>Contraceptive Agents, Hormonal - therapeutic use</subject><subject>Endocrinology</subject><subject>Endometrial cancer</subject><subject>Endometrial Hyperplasia - drug therapy</subject><subject>Endometrial Neoplasms - drug therapy</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Female</subject><subject>Gynecology</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Intrauterine Devices, Medicated</subject><subject>Levonorgestrel - administration & dosage</subject><subject>Levonorgestrel - therapeutic use</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metformin - administration & dosage</subject><subject>Metformin - therapeutic use</subject><subject>Network Meta-Analysis</subject><subject>Obstetrics/Perinatology/Midwifery</subject><subject>Progestins - administration & dosage</subject><subject>Progestins - therapeutic use</subject><subject>Review</subject><subject>Treatment Outcome</subject><issn>1432-0711</issn><issn>0932-0067</issn><issn>1432-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU1v1DAQhi0Eou3CH-CALHHhEvBXY4cbWhWKVIkLnK1ZZ9K6JHawna72b_ELcdjyeeBgecbzzDtjvYQ84-wVZ0y_zowpphom6tEtM83-ATnlSoqacv7wj_iEnOV8yxgXxrSPyYk0nWFStafk2zZOMyQo_g4pDgO6kmkcaO9rnDAUWhJCmWqU6Q4y9jQGWm6QjngXQ0zXmCsxUh9KgqVg8gFpPuSCU32jGPo4YUkeRuogOR_iBBRC_1fl5jBjmkfIHuhcd1mnvaFAA5Z9TF9o5aCBAOMh-_yEPBpgzPj0_t6Qz-8uPm0vm6uP7z9s3141Tpy3pXFat0Iqo3DHDA6m41whYOu4RKFFh505Nz0YLQaQroLA1WDUDjR2gJ2SG_LyqDun-HWp37STzw7HEQLGJVvJtOZGm3ZFX_yD3sYl1X1XquukNOsuGyKOlEsx54SDnZOfIB0sZ3Z11B4dtdVR-8NRu69Nz--ll92E_a-WnxZWQB6BXEvhGtPv2f-R_Q5MirGR</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Tao, Muheng</creator><creator>Wu, Tingting</creator><creator>Zhou, Xin</creator><creator>Du, Xiurong</creator><creator>Ling, Kaijian</creator><creator>Liang, Zhiqing</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0002-2994-3689</orcidid></search><sort><creationdate>20240901</creationdate><title>Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis</title><author>Tao, Muheng ; Wu, Tingting ; Zhou, Xin ; Du, Xiurong ; Ling, Kaijian ; Liang, Zhiqing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-c77623484eb08ef89114eae6c13e2729e9858da872fa3c348a14f84ba7e9ae943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Contraceptive Agents, Hormonal - administration & dosage</topic><topic>Contraceptive Agents, Hormonal - therapeutic use</topic><topic>Endocrinology</topic><topic>Endometrial cancer</topic><topic>Endometrial Hyperplasia - drug therapy</topic><topic>Endometrial Neoplasms - drug therapy</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Female</topic><topic>Gynecology</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Intrauterine Devices, Medicated</topic><topic>Levonorgestrel - administration & dosage</topic><topic>Levonorgestrel - therapeutic use</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metformin - administration & dosage</topic><topic>Metformin - therapeutic use</topic><topic>Network Meta-Analysis</topic><topic>Obstetrics/Perinatology/Midwifery</topic><topic>Progestins - administration & dosage</topic><topic>Progestins - therapeutic use</topic><topic>Review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tao, Muheng</creatorcontrib><creatorcontrib>Wu, Tingting</creatorcontrib><creatorcontrib>Zhou, Xin</creatorcontrib><creatorcontrib>Du, Xiurong</creatorcontrib><creatorcontrib>Ling, Kaijian</creatorcontrib><creatorcontrib>Liang, Zhiqing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of gynecology and obstetrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tao, Muheng</au><au>Wu, Tingting</au><au>Zhou, Xin</au><au>Du, Xiurong</au><au>Ling, Kaijian</au><au>Liang, Zhiqing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis</atitle><jtitle>Archives of gynecology and obstetrics</jtitle><stitle>Arch Gynecol Obstet</stitle><addtitle>Arch Gynecol Obstet</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>310</volume><issue>3</issue><spage>1315</spage><epage>1329</epage><pages>1315-1329</pages><issn>1432-0711</issn><issn>0932-0067</issn><eissn>1432-0711</eissn><abstract>Objective
Levonorgestrel intrauterine system (LNG-IUS) has been widely used in patients with endometrial carcinoma (EC), endometrial hyperplasia without atypical (EH), and atypical endometrial hyperplasia (AEH). The purpose of our Network meta-analysis (NMA) is to evaluate the efficacy of the treatments based on the LNG-IUS in patients with EC and EH with or without atypical.
Methods
We examined PubMed, EMBASE, Web of Science and the Cochrane Library up to 22 April 2024 to determine studies reporting treatment outcomes in EC and EH patients receiving LNG-IUS therapy, LNG-IUS + metformin (MET), oral progestins (OP), etc. We used EndNote 9 to select studies, Jadad scale and NOS scale to assess quality, stata(16.0) and R (4.3.1) to analysis the data.
Results
Overall, 28 studies involving 3752 patients were included in our NMA. As for EH patients, LNG-IUS (RR 1.21; 95% CrI [1.11, 1.34]) and LNG-IUS + MET (RR 323.57; 95% CrI [1.61, 214,223,188.1])] significantly increased CR rate in comparison with OP. Based on SUCRA, LNG-IUS + OP was the best treatment to improve CR(SUCRA = 67.2%) in patients with EC, whereas LNG-IUS + MET was superior in increasing CR (SUCRA = 99.8%) than any other treatments for EH patients. Besides, the ranking based on SUCRA illustrated that LNG-IUS alone was the best choice to raise CR rates (SUCRA = 76.7%) for AEH patients. In head-to-head meta-analysis, OP has a higher progression rate (RR 4, 95% CI 1.89–8.46,
p
= 0.062;
I
2
= 71.3%), a higher nausea rate (RR 1.93, 95% CI 1.24–3.01,
p
= 0.187;
I
2
= 40.4%) than LNG-IUS in patients with EH. In contrast, LNG-IUS had a irregular vaginal bleeding rates (RR 0.76, 95% CI 0.64–0.90,
p
= 0.034;
I
2
= 77.7%) than OP in EH patients. In addition, as for AEH patients, OP has a higher persistence rate (RR 4.31, 95% CI 1.43–13.00,
p
= 0.93;
I
2
= 0.0%) than LNG-IUS.
Conclusion
According to the NMA, LNG-IUS related studies are feasible for conservative therapy in patients with EC and EH with or without atypical. Therefore, concerning the curative effect, we recommend LNG-IUS-based treatments as the best conservative therapy for EC and EH patients. However, future studies require large sample sizes and more outcomes to further evaluate the differences of treatment selections based on LNG-IUS.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38980346</pmid><doi>10.1007/s00404-024-07608-w</doi><tpages>15</tpages><orcidid>https://orcid.org/0009-0002-2994-3689</orcidid></addata></record> |
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| subjects | Contraceptive Agents, Hormonal - administration & dosage Contraceptive Agents, Hormonal - therapeutic use Endocrinology Endometrial cancer Endometrial Hyperplasia - drug therapy Endometrial Neoplasms - drug therapy Endometrial Neoplasms - pathology Female Gynecology Human Genetics Humans Hyperplasia Intrauterine Devices, Medicated Levonorgestrel - administration & dosage Levonorgestrel - therapeutic use Medicine Medicine & Public Health Metformin - administration & dosage Metformin - therapeutic use Network Meta-Analysis Obstetrics/Perinatology/Midwifery Progestins - administration & dosage Progestins - therapeutic use Review Treatment Outcome |
| title | Comparative effects of different treatments based on the levonorgestrel intrauterine system in endometrial carcinoma and endometrial hyperplasia patients: a network meta-analysis |
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