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World J Clin Oncol. Oct 24, 2026; 17(10): 123273
Published online Oct 24, 2026. doi: 10.5306/wjco.123273
Published online Oct 24, 2026. doi: 10.5306/wjco.123273
Endometrial polypoid adenomyoma outcomes and fertility-sparing treatments efficacy for atypical type: A systematic review and network meta-analysis
Jie-Zhuang Huang, Ya-Wen Deng, Cai-Ni Wei, Shu-Li Tang, Zhi-Fu Zhi, Department of Gyne
Xia Liu, Department of Gynecology and Obstetrics, Guangxi International Zhuang Medicine Hospital, Nanning 530001, Guangxi Zhuang Autonomous Region, China
Author contributions: Huang JZ was responsible for drafting the manuscript; Liu X worked for data curation and formal analysis; Deng YW and Wei CN were devoted to data collection and curation; Tang SL was accountable for investigation and formal analysis; Zhi ZF taken protocol design, project administration, and review and editing writing; the manuscript has been read and approved by all the authors and the authorship as stated earlier in this document have been met; and each author believes that the manuscript represents honest work.
AI contribution statement: No AI tool was used to generate research data, interpret results, or formulate conclusions.
Conflict-of-interest statement: There are no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Zhi-Fu Zhi, MD, Department of Gynecology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. zhizhifu525@163.com
Received: May 14, 2026
Revised: July 15, 2026
Accepted: September 24, 2026
Published online: October 24, 2026
Processing time: 161 Days and 21.7 Hours
Revised: July 15, 2026
Accepted: September 24, 2026
Published online: October 24, 2026
Processing time: 161 Days and 21.7 Hours
Core Tip
Core Tip: Atypical polypoid adenomyoma (APA) carries a significantly higher risk of concurrent endometrial hyperplasia and cancer than typical polypoid adenomyoma. In this first network meta-analysis comparing fertility-sparing treatments for APA, transcervical resection of polyps (TCRP) followed by medroxyprogesterone acetate (10 mg/day) proved most effective for achieving complete response and preventing recurrence. Additionally, TCRP with subsequent high-dose progestin was most effective for preventing cancer progression. These findings provide critical evidence-based guidance for managing APA in reproductive-aged women.