von Kartaschew Åsa Ehlin, Dahm-Kähler Pernilla, Rodriguez-Wallberg Kenny A, Holmberg Erik, Rådestad Angelique Flöter
Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Division of Neonatology, Obstetrics and Gynecology, Karolinska Institute, Stockholm, Sweden.
Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Gynecol Oncol. 2022 Dec;167(3):476-482. doi: 10.1016/j.ygyno.2022.09.027. Epub 2022 Oct 8.
To study the extent of hormone replacement therapy (HRT) dispensing in premenopausal women after being treated with bilateral salpingo-oophorectomy (BSOE) for ovarian cancer (OC).
Nationwide population- and register-based cohort study including women 18-50 years old, registered in The Swedish Quality Register for Gynecological Cancer (SQRGC), where BSOE was performed due to epithelial (EOC) and non-epithelial ovarian cancers (NEOC) or borderline ovarian tumor (BOT) between 2008 and 2014. Data on HRT dispensing was obtained from the National Prescribed Drug Register analyzed at semi-annual intervals from surgery until end of follow-up December 2015, including a logistic regression analysis.
A cohort of 664 women were identified with OC, whereas 396 women had an EOC, 61 a NEOC and 207 a BOT. At surgery 49% of the women were ≤44 years. HRT dispensed to the total cohort varied between 32% and 41% the first five years after surgery. During follow-up at first 0.5-1 year 51% of the women <40 years were dispensed HRT compared to 25% of women ≥40 years. Of women with EOC, 21% dispensed HRT at first 0.5-1 year. In the multivariable regression analysis; age <40 (OR6.17, p < 0.001) and age 40-44 (OR2.95, p < 0.001) as well as BOT histology (OR3.84, p < 0.001) were found significant variables for dispensing of HRT.
A majority of premenopausal women undergoing BSOE for OC did not use HRT postoperatively. Our study shows that there is a need to address HRT use after OC treatment in young women to prevent from morbidity and a poorer quality of life.
研究因卵巢癌（OC）接受双侧输卵管卵巢切除术（BSOE）的绝经前女性接受激素替代疗法（HRT）的情况。
基于全国人口和登记册的队列研究，纳入年龄在18至50岁之间、登记在瑞典妇科癌症质量登记册（SQRGC）中的女性，她们在2008年至2014年间因上皮性（EOC）和非上皮性卵巢癌（NEOC）或交界性卵巢肿瘤（BOT）接受了BSOE。从国家处方药登记册获取HRT配药数据，从手术到2015年12月随访结束，每半年分析一次，包括逻辑回归分析。
确定了664名患有OC的女性队列，其中396名患有EOC，61名患有NEOC，207名患有BOT。手术时，49%的女性年龄≤44岁。术后前五年，整个队列接受HRT配药的比例在32%至41%之间。在随访的前0.5至1年，<40岁的女性中有51%接受了HRT配药，而≥40岁的女性中这一比例为25%。患有EOC的女性中，21%在最初的0.5至1年接受了HRT配药。在多变量回归分析中，年龄<40岁（OR6.17，p<0.001）、年龄40至44岁（OR2.95，p<0.001）以及BOT组织学（OR3.84，p<0.001）被发现是HRT配药的显著变量。
大多数因OC接受BSOE的绝经前女性术后未使用HRT。我们的研究表明，有必要关注年轻女性OC治疗后的HRT使用情况，以预防发病和生活质量下降。
