abstract
BACKGROUND:
.
Hormone replacement therapy (HRT) has been proven highly effective for
menopausal symptoms caused by radical surgery. However, the impact of
postoperative HRT on the clinical outcomes of patients previously
treated for epithelial
ovarian cancer (EOC) remains unclear.
OBJECTIVE:
.
To determine whether postoperative HRT use has any positive or negative
impacts on prognosis and recurrence among EOC survivors.
METHODS:
.
Studies that provided an assessment of postoperative HRT use and
prognosis or recurrence in EOC patients were included for analysis. Two
reviewers independently evaluated the eligibility of identified studies
and abstracted the data. A fixed effects model was used to pool
study-specific estimates of hazard ratios (HRs) or relative risks (RRs)
with 95% confidence intervals (CIs).
RESULTS:
.
Two randomized controlled trials (RCTs) and four cohort studies
included 419 EOC survivors who used HRT and 1,029 non-users. The
aggregated HR of overall survival (OS) suggested that HRT use after
surgery for EOC had a favorable impact on OS (HR=0.69, 95% CI:
0.61-0.79), but when these studies were categorized into cohort study
and RCT subgroups, not all of them demonstrated positive results
(HR=0.63, 95% CI: 0.49-0.81 and HR=1.03, 95% CI: 0.58-1.83,
respectively).
The meta-analysis of EOC recurrence of three available
studies demonstrated that postoperative HRT use was not associated with
an increased risk of recurrence in EOC survivors (RR=0.83, 95% CI:
0.64-1.07).
This pattern also emerged in the subgroup analysis for the
stage and type of HRT.
CONCLUSIONS:
.
In EOC patients, postoperative HRT does not have a negative effect on
overall survival and tumor recurrence. However, well-designed and
large-scale RCTs are needed to verify this relationship in the future.
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