为了检查黄体激素再处理对再发性子宫内上皮内瘤样病变（EIN）、不典型子宫内膜增生症（AH）和子宫内膜癌（EC）的有效性，进行了一项由日本妇产科肿瘤学会子宫内膜癌委员会的专家小组进行的综合系统评价和Meta分析。在2021年12月，使用关键词“子宫内肿瘤”、“子宫内膜增生症”、“子宫内上皮内瘤样病变”、“生育保护”、“黄体激素”和“复发” 检索多个搜索引擎，包括PubMed / MEDLINE和Cochrane数据库。比较了描述EIN、AH和EC的黄体激素再处理的病例与进行传统子宫切除的病例。主要结果是生存和疾病复发，次要结果是怀孕。在筛选了238项研究后，确定出32项有关复发治疗的结果。这些研究包括365名患者（270名接受了黄体激素再处理，95名接受了子宫切除）。大多数黄体激素再处理涉及甲烷酸甲羟孕酮或美格氯酮醇酸盐（94.5%）。81.1%的病例通过黄体激素再处理实现完全缓解（CR），3、6和9个月的累积CR率分别为22.8%、51.7%和82.6%。相比传统的子宫切除，黄体激素再处理与更高的疾病复发风险相关（盘算比[OR]=6.78；95%置信区间[CI]=1.99-23.10），且1名患者（0.4%）死于疾病。51名女性（14.0%）在复发后怀孕，并且黄体激素再处理展示了怀孕的可能性（OR=2.48；95% CI=0.94-6.58）。这项Meta分析表明，重复应用黄体激素疗法是一种有效的选择，适用于希望保留其生育能力的复发EIN、AH和EC患者。 © 2023亚洲妇产科肿瘤学会、韩国妇产科肿瘤学会和日本妇产科肿瘤学会。

To examine the effectiveness of progestin re-treatment for recurrent endometrial intraepithelial neoplasia (EIN), atypical endometrial hyperplasia (AH) and endometrial cancer (EC) following initial fertility-sparing treatment. A comprehensive systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Endometrial Cancer Committee. Multiple search engines, including PubMed/MEDLINE and the Cochrane Database, were searched in December 2021 using the keywords "Endometrial neoplasms," "Endometrial hyperplasia," "Endometrial intraepithelial neoplasia," "Fertility preservation," "Progestins," AND "Recurrence." Cases describing progestin re-treatment for recurrent EIN, AH and EC were compared with cases that underwent conventional hysterectomy. The primary outcomes were survival and disease recurrence, and the secondary outcome was pregnancy. After screening 238 studies, 32 with results for recurrent treatment were identified. These studies included 365 patients (270 received progestin re-treatment and 95 underwent hysterectomy). Most progestin re-treatment involved medroxyprogesterone acetate or megestrol acetate (94.5%). Complete remission (CR) following progestin re-treatment was achieved in 219 (81.1%) cases, with 3-, 6- and 9-month cumulative CR rates of 22.8%, 51.7% and 82.6%, respectively. Progestin re-treatment was associated with higher risk of disease recurrence than conventional hysterectomy was (odds ratio [OR]=6.78; 95% confidence interval [CI]=1.99-23.10), and one patient (0.4%) died of disease. Fifty-one (14.0%) women became pregnant after recurrence, and progestin re-treatment demonstrated a possibility of pregnancy (OR=2.48; 95% CI=0.94-6.58). This meta-analysis suggests that repeat progestin therapy is an effective option for women with recurrent EIN, AH and EC, who wish to retain their fertility.© 2023. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.