Menopausal hormone therapy prior to the diagnosis of ovarian cancer is associated with improved survival
Menopausal hormone therapy prior to the diagnosis of ovarian cancer is associated with improved survival
复制标题
DOI：
10.1016/j.ygyno.2020.06.481
复制
发表时间：
2020-09-01
影响因子：
4.7
通讯作者：
Pearce, Celeste Leigh
中科院分区：
文献类型：
--
作者：
Brieger, Katharine K.;Peterson, Siri;Pearce, Celeste Leigh
目的。以往关于绝经激素治疗(MHT)和卵巢癌生存率的研究由于缺乏激素方案的细节和样本量不足而受到限制。为了解决这些局限性，对6419例经病理证实的绝经后卵巢癌妇女进行了全面的分析，以检验诊断前使用MHT与生存之间的关系。其中包括来自卵巢癌协会联合会的15项研究的数据。MHT的使用按类型(仅使用雌激素(ET)或雌激素+孕激素(EPT))、持续时间和最近使用相对于诊断进行检查。使用COX比例风险模型来估计激素治疗的使用与生存之间的关系。运用Logistic回归和中介分析，探讨MHT的使用与去势手术后残留病的关系。诊断前使用ET或EPT至少五年与卵巢癌较好的生存相关(风险比为0.80；95%可信区间为0.74至0.87)。在晚期、高级别浆液性癌的女性中，那些使用MHT的女性在初次去髓核手术时不太可能有任何肉眼残留疾病(p
Purpose. Prior studies of menopausal hormone therapy (MHT) and ovarian cancer survival have been limited by lack of hormone regimen detail and insufficient sample sizes. To address these limitations, a comprehensive analysis of 6419 post-menopausal women with pathologically confirmed ovarian carcinoma was conducted to examine the association between MHT use prior to diagnosis and survival.Methods. Data from 15 studies in the Ovarian Cancer Association Consortium were included. MHT use was examined by type (estrogen-only (ET) or estrogen+progestin (EPT)), duration, and recency of use relative to diagnosis. Cox proportional hazards models were used to estimate the association between hormone therapy use and survival. Logistic regression and mediation analysis was used to explore the relationship between MHT use and residual disease following debulking surgery.Results. Use of ET or EPT for at least five years prior to diagnosis was associated with better ovarian cancer survival (hazard ratio, 0.80; 95% CI, 0.74 to 0.87). Among women with advanced stage, high-grade serous carcinoma, those who used MHT were less likely to have any macroscopic residual disease at the time of primary debulking surgery (p for trend