Ursic-Vrscaj M, Bebar S, Zakelj M P
Department of Gynecological Oncology, Institute of Oncology, Ljubljana, Slovenia.
Menopause. 2001 Jan-Feb;8(1):70-5. doi: 10.1097/00042192-200101000-00012.
Our report deals with the presumed influence of hormone replacement therapy (HRT) on the survival of patients with invasive ovarian serous cystadenocarcinoma.
We selected a group of 24 patients with the diagnosis of invasive ovarian serous cystadenocarcinoma who were treated with HRT after primary surgical treatment. Each patient from the selected group was compared with two patients from the control group with the same diagnosis who did not receive HRT. The matching criteria were the age at the time of the diagnosis, year of the diagnosis, stage of the disease, differentiation, residual tumor after first operation, and disease-free interval until receiving HRT. We used Cox regression to calculate odds ratios as estimates of the effect of HRT on overall survival in the patients with invasive ovarian serous cystadenocarcinoma who did or did not receive HRT after diagnosis.
HRT was started an average of 21 months (range, 1-25 months) after diagnosis, and lasted for an average of 24 months (range, 1-70 months). After taking into account the effects of other known prognostic factors (the age at the time of the diagnosis, stage of the disease, differentiation, type of operation, residual tumour before the first operation), the estimated risk of death in patients with invasive ovarian serous cystadenocarcinoma who received HRT was 0.90 (odds ratio = 0.90; 95% confidence interval, 0.24-5.08).
The results of our small study are only preliminary and suggest that HRT does not have a pronounced effect on survival. A single center can scarcely obtain a sufficient number of such a specific group of cancer patients; therefore, the collaboration of different institutions, preferably in a randomized, controlled trial, is needed for more reliable results.
本报告探讨激素替代疗法(HRT)对侵袭性卵巢浆液性囊腺癌患者生存率的假定影响。
我们选取了一组24例经诊断为侵袭性卵巢浆液性囊腺癌的患者,这些患者在初次手术治疗后接受了HRT。所选组中的每例患者与对照组中两名诊断相同但未接受HRT的患者进行比较。匹配标准为诊断时的年龄、诊断年份、疾病分期、分化程度、首次手术后的残留肿瘤以及接受HRT前的无病间期。我们使用Cox回归计算比值比,以估计HRT对诊断后接受或未接受HRT的侵袭性卵巢浆液性囊腺癌患者总生存的影响。
HRT在诊断后平均21个月(范围1 - 25个月)开始,平均持续24个月(范围1 - 70个月)。在考虑其他已知预后因素(诊断时的年龄、疾病分期、分化程度、手术类型、首次手术前的残留肿瘤)的影响后,接受HRT的侵袭性卵巢浆液性囊腺癌患者的估计死亡风险为0.90(比值比 = 0.90;95%置信区间,0.24 - 5.08)。
我们这项小型研究的结果仅为初步结果,表明HRT对生存率没有显著影响。单个中心很难获得足够数量的此类特定癌症患者群体;因此,需要不同机构合作,最好进行随机对照试验,以获得更可靠的结果。