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Progestagens for endometrial cancer.
L Martin-Hirsch P1, G Jarvis, H Kitchener
1University Department of Obstetrics and Gynaecology, St Mary's Hospital, Whitworth Park, Manchester, UK, M13 0JH.
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Adjuvant progestagen therapy for endometrial cancer did not improve overall survival. While it may reduce cancer deaths and relapses, it increased non-cancer related deaths, questioning its overall benefit.
Area of Science:
- Gynecologic Oncology
- Pharmacological Therapy
- Cancer Recurrence
Background:
- Adjuvant progestagen therapy is sometimes recommended after surgery for endometrial cancer to lower recurrence risk.
- The effectiveness and safety of this adjuvant therapy require thorough evaluation.
Purpose of the Study:
- To systematically review the impact of adjuvant progestagen therapy on endometrial cancer outcomes following primary surgical treatment.
Main Methods:
- Searched major databases (Cochrane Gynaecological Cancer Group, MEDLINE) up to May 1999.
- Included randomized trials of progestagen therapy in women post-endometrial cancer surgery.
- Assessed trial quality and abstracted data independently.
Main Results:
- Six trials with 4351 women were analyzed, including early and advanced stages.
- Progestagen therapy did not enhance overall survival (OR 1.05).
- While potentially reducing endometrial cancer deaths and relapses, it was associated with increased non-endometrial cancer deaths (OR 1.33).
Conclusions:
- Current evidence does not support the routine use of adjuvant progestagen therapy in the primary management of endometrial cancer.
- The observed increase in non-cancer related mortality warrants caution.
- Further research may be needed to clarify the role of progestagens in specific patient subgroups.