Yokoyama Yoshihito, Ito Kiyoshi, Takamatsu Kiyoshi, Takehara Kazuhiro, Nakanishi Toru, Harano Kenichi, Watari Hidemichi, Susumu Nobuyuki, Aoki Daisuke, Saito Toshiaki
Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Department of Disaster Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, 980-8573, Japan.
Int J Clin Oncol. 2015 Oct;20(5):997-1004. doi: 10.1007/s10147-015-0808-5. Epub 2015 Mar 6.
This survey sought to determine Japanese gynecologists' attitudes concerning administering hormone replacement therapy (HRT) for patients after surgery for endometrial cancer (EC).
Eight hundred and eighty-eight members of the Japanese Gynecologic Oncology Group (JGOG) were asked to respond to an anonymous questionnaire on the JGOG website. The survey asked whether or not HRT was to be administered when surgery was performed (including a hysterectomy and bilateral oophorectomy) to treat EC before or after menopause. If HRT was not to be administered, respondents were asked the reason why. Respondents were presented with the same hypothetical patients that were featured in a previous survey in Germany, and differences in the mindsets of Japanese and German physicians were compared.
Responses from 363 individuals (response rate 40.9 %) were analyzed. Seventy-eight percent of physicians considered HRT for patients undergoing surgery before menopause. The most prevalent reason of refusal to prescribe HRT was the risk of EC recurrence. Forty-eight percent of physicians considered HRT for patients undergoing surgery after menopause. The most prevalent reasons of refusal of HRT were its limited benefit and the availability of alternative therapies. Sixty-five percent of Japanese physicians responded that they would administer HRT to patients with low risk of recurrence vs. 46 % of physicians in Germany (P < 0.0002). Forty-nine percent of Japanese physicians approved of prescribing HRT for patients with high risk of recurrence vs. 25 % of physicians in Germany (P < 0.0001).
Many Japanese gynecologists have a favorable attitude toward prescribing HRT after treatment of EC.
本调查旨在确定日本妇科肿瘤学家对于子宫内膜癌(EC)手术后患者进行激素替代疗法(HRT)的态度。
日本妇科肿瘤学组(JGOG)的888名成员被要求在JGOG网站上回答一份匿名问卷。该调查询问在绝经前后进行手术(包括子宫切除术和双侧卵巢切除术)治疗EC时是否要进行HRT。如果不进行HRT,会询问受访者原因。向受访者展示了与德国之前一项调查中相同的假设患者,并比较了日本和德国医生观念上的差异。
分析了363人的回复(回复率40.9%)。78%的医生考虑为绝经前接受手术的患者进行HRT。拒绝开具HRT最常见的原因是EC复发风险。48%的医生考虑为绝经后接受手术的患者进行HRT。拒绝HRT最常见的原因是其益处有限以及有替代疗法。65%的日本医生表示他们会给复发风险低的患者使用HRT,而德国这一比例为46%(P<0.0002)。49%的日本医生赞成给复发风险高的患者开具HRT,而德国这一比例为25%(P<0.0001)。
许多日本妇科肿瘤学家对于EC治疗后开具HRT持积极态度。