Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres' ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen

Autor:	L, Bergman, M L, Beelen, M P, Gallee, H, Hollema, J, Benraadt, F E, van Leeuwen
Rok vydání:	2000
Předmět:	Time Factors Antineoplastic Agents Hormonal Estrogen Antagonists Breast Neoplasms Middle Aged Prognosis Risk Assessment Endometrial Neoplasms Gene Expression Regulation Neoplastic Survival Rate Tamoxifen Receptors Estrogen Risk Factors Case-Control Studies Humans Female Tumor Suppressor Protein p53 Aged Neoplasm Staging Proportional Hazards Models
Zdroj:	Lancet (London, England). 356(9233)
ISSN:	0140-6736
Popis:	Tamoxifen increases the risk of endometrial cancer. However, few studies have produced reliable risk estimates by duration, dose, and recency of use, or addressed the prognosis of endometrial cancers in tamoxifen-treated women.We did a nationwide case-control study on the risk and prognosis of endometrial cancer after tamoxifen use for breast cancer. Information on tamoxifen use and other risk factors for endometrial cancer was obtained from 309 women with endometrial cancer after breast cancer (cases), and 860 matched controls with breast cancer but without endometrial cancer. For 276 cases, we obtained tissue blocks of endometrial cancer to review the diagnosis, and used immunohistochemistry to examine hormone-receptor status and overexpression of p53.Tamoxifen had been used by 108 (36.1%) of 299 cases and 245 (28.5%) controls (relative risk 1.5 [95% CI 1.1-2.0]). Risk of endometrial cancer increased with longer duration of tamoxifen use (p0.001), with relative risks of 2.0 (1.2-3.2) for 2-5 years and 6.9 (2.4-19.4) for at least 5 years compared with non-users. Endometrial cancers of stage III and IV occurred more frequently in long-term tamoxifen users (or = 2 years) than in non-users (17.4% vs 5.4%, p=0.006). Long-term users were more likely than non-users to have had malignant mixed mesodermal tumours or sarcomas of the endometrium (15.4% vs 2.9%, por = 0.02), p53-positive tumours (31.4% vs 18.2%, p=0.05), and negative oestrogen-receptor concentrations (60.8% vs 26.2%, por = 0.001). 3-year endometrial-cancer-specific survival was significantly worse for long-term tamoxifen users than for non-users (76% foror = 5 years, 85% for 2-5 years vs 94% for non-users, p=0.02).Long-term tamoxifen users have a worse prognosis of endometrial cancers, which seems to be due to less favourable histology and higher stage. However, the benefit of tamoxifen on breast-cancer survival far outweighs the increased mortality from endometrial cancer. Nevertheless, we seriously question widespread use of tamoxifen as a preventive agent against breast cancer in healthy women.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::14194f71cd932a74d6b80fbd1b2b1cec https://pubmed.ncbi.nlm.nih.gov/11197382 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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