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Progestagens for endometrial cancerMartin-Hirsch PPL, Jarvis GG, Kitchener HC, Lilford R
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SummaryProgestagens for endometrial cancerNo evidence to support use of adjuvant progestagens to prevent recurrence of endometrial cancer after surgery. Endometrial cancer is becoming the most common genital tract cancer in many western countries. Progestagen (a hormone) therapy is sometimes used following initial surgery to reduce the risk of recurrence. However, progestagens have been found to reduce one of the protective factors against heart disease and may also make tumours more resistant to radiotherapy. This review found no evidence to support the use of progestagen as an addition to surgery for newly diagnosed endometrial cancer. Progestagen can, however, shrink recurrent cancer in some patients.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 2, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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January 26. 1998 AbstractBackgroundEndometrial cancer is the most common genital tract carcinoma in many western countries, with the majority (approximately 75%) of women presenting with stage 1 disease. The overall unadjusted five year survival for stage 1 disease is relatively high at 75% , but women with poor prognostic factors within stage 1 can have a survival expectancy as low as 26%. Adjuvant progestagen therapy has been advocated following primary surgery to reduce the risk of recurrence of disease. We have reviewed the effectiveness of this therapy. ObjectivesProgestagen therapy following primary surgery for endometrial cancer has been advocated to reduce the risk of recurrence. The objective of this review was to assess the effect of adjuvant progestagen therapy in endometrial cancer. Search strategyWe searched the Cochrane Gynaecological Cancer Group trials register and MEDLINE up to May 1999. Selection criteriaRandomised trials of progestagen therapy in women who have had surgery for endometrial cancer. Data collection and analysisTrial quality was assessed and two reviewers abstracted data independently. Main resultsSix trials involving 4351 women were identified. Three trials included women with stage one disease only, whereas three included women with more advanced disease. Based on five trials, overall survival was not improved by adjuvant progestagen therapy (OR 1.05, 95% CI 0.88 to 1.24). Endometrial cancer deaths and relapse of disease appears to be reduced by progestagen therapy OR 0.88 95% CI (0.71-1.1) and 0.81 95% CI (0.65-1.01) respectively. However, non-endometrial cancer related deaths were more common in women treated with progestagens OR 1.33 (1.02-1.73). Authors' conclusionsCurrent evidence does not support the use of adjuvant progestagen therapy in the primary treatment of endometrial cancer. |