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| |  Fewer Incidences Of Endometrial Cancer Recurrence In Patients Who Take Estrogen SAN DIEGO, CA -- February 7, 2000 -- A study investigating the effects of Estrogen Replacement Therapy (ERT) on endometrial cancer survivors (the largest to date) was presented at the Society of Gynecologic Oncologists annual meeting. The study was conducted by Philip J. DiSaia, M.D.; Kimberly A. Suriano, M.D.; Michael McHale, M.D.; Alessandra Re, M.D.; and Christine McLaren Ph.D. from University of California Irvine Medical Center, Orange, CA and the Chao Family Comprehensive Cancer Center, Orange, CA. With approximately 37,400 new cases diagnosed in 1999, endometrial cancer constitutes the fourth most common malignancy in American women. "The benefits gained from ERT use among women previously diagnosed and treated for endometrial cancer has long been surrounded by controversy. This study was conducted in an attempt to demystify ERT's role in women with a history of endometrial cancer and provide clinicians with the most current data through which they can help their patients make informed decisions regarding ERT," said Dr. Philip DiSaia, Dorothy Marsh Chair in Reproductive Biology, Professor, Department of Obstetrics and Gynecology, and Director, Division of Gynecologic Oncology. Study subjects were chosen from 130 women with endometrial cancer who elected to receive post-therapy estrogens. The control group consisted of 75 pairings with non-estrogen using endometrial cancer patients. The two groups were matched for age, parity, FIGO surgical stage, cell type, nuclear grade, type of surgical treatment, lymph node status, use of post-operative adjuvant radiotherapy and concurrent diseases. Demographic and clinical data included: age at diagnosis, parity, presence of intercurrent disease, method of surgical treatment, postoperative adjuvant therapy (chemotherapy or radiotherapy), FIGO surgical stage, grade, depth of invasion, lymph node status and preoperative use of hormones. The study monitored recurrence of endometrial cancer, death from endometrial cancer and death from intercurrent/overlapping illness. Therefore the study measures were recurrence rate, disease free interval and disease free survival as compared to the estrogen and non-estrogen users. Statistically the patients treated with hormones were compared to their control counterparts by means of a chi-square analysis for discrete variables and with two-tailed t tests for the continuous variables. Every three months for the first two years all 150 patients were screened by way of a pelvic examination and vaginal Papanicolaou test, after which the screening interval was increased to six months. At a median interval of 83 months, two local recurrences have been documented among the 75 estrogen users, while 11 women from the non-estrogen user group have failed either locally (n=8) or at distant sites (n=3) at a median 69 months follow-up (p=N.S.). The median disease free intervals for the estrogen users (82 months) reaches statistical significance when compared to that for the non-estrogen users (63 months) (p= 0.02). Interestingly, there were no recurrences among the women who gave a history of previous HRT use (49 percent of the estrogen users and 13 percent of the non-estrogen users). Findings show that estrogen users were less likely to experience disease recurrence; in fact, a statistically significant survival advantage was afforded this group. The established long-term health benefits of estrogen replacement as it impacts the quality of life seems to outweigh the as yet unfounded theoretical risk of disease recurrence. Appropriate counseling should include a discussion of the available non-hormonal preparations through which some of the benefits of estrogen replacement may be gained. Related Link: Hormone Replacement Therapy (HRT).
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