Adjuvant Hormone Therapy May Improve Survival in Epithelial Ovarian Cancer: Results of the AHT Randomized Trial
| Autor: | Janine Mansi, Richard Osborne, James P Morden, John Glees, Chris Williams, Miklos Wenczl, Henry C Kitchener, Judith M Bliss, Peter Harper, Martin Gore, David Guthrie, Rosalind A. Eeles |
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| Rok vydání: | 2015 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment Malignancy law.invention Randomized controlled trial law Internal medicine medicine Carcinoma Epithelial ovarian cancer Stage (cooking) Gynecology Chemotherapy Postmenopausal women Random assignment business.industry Obstetrics and Gynecology Hormone replacement therapy (menopause) General Medicine Odds ratio medicine.disease Hormone therapy business Adjuvant |
| Zdroj: | Journal of Clinical Oncology. 33:4138-4144 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose To assess the effects of adjuvant hormone therapy (AHT) on survival and disease outcome in women with epithelial ovarian cancer. Patients and Methods Participants were premenopausal and postmenopausal women who had been diagnosed with epithelial ovarian cancer (any International Federation of Gynecology and Obstetrics stage) 9 or fewer months previously. Ineligible patients included those with deliberately preserved ovarian function, with a history of a hormone-dependent malignancy, or with any contraindications to hormone-replacement therapy. Patients were centrally randomly assigned in a 1:1 ratio to either AHT for 5 years after random assignment or no AHT (control). Main outcome measures were overall survival (OS), defined as time from random assignment to death (any cause), and relapse-free survival, defined as time from random assignment to relapse or death (any cause). Patients who continued, alive and relapse free, were censored at their last known follow-up. Results A total of 150 patients (n = 75, AHT; n = 75, control) were randomly assigned from 1990 to 1995 from 19 centers in the United Kingdom, Spain, and Hungary; all patients were included in intention-to-treat analyses. The median follow-up in alive patients is currently 19.1 years. Of the 75 patients with AHT, 53 (71%) have died compared with 68 (91%) of 75 patients in the control group. OS was significantly improved in patients who were receiving AHT (hazard ratio, 0.63; 95% CI, 0.44 to 0.90; P = .011). A similar effect was seen for relapse-free survival (hazard ratio, 0.67; 95% CI, 0.47 to 0.97; P = .032). Effects remained after adjustment for known prognostic factors. Conclusion These results show that women who have severe menopausal symptoms after ovarian cancer treatment can safely take hormone-replacement therapy, and this may, in fact, infer benefits in terms of OS in addition to known advantages in terms of quality of life. |
| Databáze: | OpenAIRE |
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