Progress in menopausal hormone therapy for postoperative patients with gynecological malignant cancer

doi:10.19401/j.cnki.1007-3639.2022.11.008

Abstract

Abstract:

Menopausal hormone therapy (MHT) is an effective therapy for alleviating menopausal symptoms in postmenopausal patients. Clinically, the safety and effectiveness of MHT in postoperative patients with gynecological malignant tumors are the most important. We reviewed the clinical studies on MHT after surgical treatment of gynecological malignant tumors in recent five years. The comprehensive results showed that MHT after surgical treatment of early endometrial cancer (EC) did not increase the risk of recurrence and improved the quality of life. Postoperative MHT has no adverse effect on disease-free survival and overall survival in patients with epithelial ovarian cancer (OC), however it is not recommended for other non-epithelial ovarian tumors such as ovarian sex cord stromal tumor. MHT is relatively safe after surgical treatment of cervical squamous cell carcinoma, however there are few studies on the postoperative use of MHT in cervical adenocarcinoma, vulvar cancer and vaginal cancer patients, and no definite conclusions are available at present. This review aimed to update the understanding of postoperative hormone therapy for gynecological malignant tumors and provide reference for improving the patients’ life quality and selecting MHT regimen rationally.

Key words: Menopausal hormone therapy, Gynecologic cancer, Endometrial cancer, Ovarian cancer, Iatrogenic menopause, Recurrence risk

CLC Number:

R737.3

ZHAO Mingming, WANG Tianyou, WANG Chao. Progress in menopausal hormone therapy for postoperative patients with gynecological malignant cancer[J]. China Oncology, 2022, 32(11): 1098-1104.

Figures/Tables 1

References 42

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Author	Study type	Tumor type	Stage	Histology	Number of MHT group	Number of non-MHT group	Median follow-up time	Hormone type	Dosage	Route	HR/OR of recurrence
Cho H W,et al^[10]	Retrospective cohort study	EC	>95% stageⅠ	NA	847	4820	4 years	Estrogen only	NA	NA	HR = 0.39, 95% CI : 0.23-0.71, P = 0.002
								Estrogen plus progesterone			HR = 0.45, 95% CI : 0.29-0.98, P = 0.034
								Tibolone only			HR = 0.50, 95% CI : 0.35-0.84, P = 0.008
								Progesterone only			HR = 0.89, 95% CI : 0.62-1.43, P = 0.588
Lim S,et al^[11]	Retrospective case-controlled study	EC	Ⅰ/Ⅱ	NA	58	116	MHT group 5.3 years, non-MHT group 3 years	DRSP/E2	2 mg/1 mg/d	Oral
Eeles R A,et al^[16]	Retrospective analysis	OC	All	Epithelial OC	75	75	19.1 years	CE, CE plus progestin	NA	Oral/patch/plant	NA
Power L,et al^[19]	Meta analysis	OC	All	Nonserous epithelial OC	94	263	3.2 years	CEE, CEE plus progestin, progestin alone	NA	Oral/vaginal	NA
Zhang Y L,et al^[20]	Retrospective case-controlled study	OC	All	Serous epithelial OC	31	81	MHT group 4.9 years non-MHT group 4.2 years	CEE	0.3 mg/d	Oral	No relationship, P=0.741
								CEE plus Tibolone	0.3 mg+ 1.25 mg/d
								Tibolone	1.25 mg/d
Richardson A, et al^[29]	Retrospective case-controlled study	CC	ⅠB-ⅡB	Adenocarcinoma	20	13	NA	NA	NA	NA	NA