[HORMONE REPLACEMENT THERAPY AFTER GYNECOLOGICAL MALIGNANCIES]

Treatment of gynecological malignancies can cause an abrupt onset of menopausal symptoms along with associated long term morbidity. Hormone replacement therapy (HRT) is the most effective treatment to alleviate these symptoms but the safety of HRT among gynecologic oncology patients remains controversial. We conducted a review of the published literature on the risk of recurrent disease among gynecologic cancer patients using HRT. Our research revealed a shortage of prospective, randomized trials on this important subject. The current evidence, mainly cohort studies, did not find an increased risk of recurrence for endometrial cancer in women with early stage disease or increased risk for recurrent ovarian epithelial cancer among HRT users after oncological treatment. Vulvar cancer and most cases of cervical cancer are presumably hormone independent malignancies and the small number of published works did not find an increased risk of recurrence among HRT users. In summary, according to current literature, there is no clear contraindication to HRT among gynecological cancer patients. Treatment should be individualized and the lack of good evidence, along with the advantages and possible disadvantages of this treatment, should be discussed with patients.