Study subjects were chosen from 130 women with endometrial cancer who elected to receive post-therapy estrogens. The control group consisted of 75 pairings with non-estrogen using endometrial cancer patients. The two groups were matched for age, parity, FIGO surgical stage, cell type, nuclear grade, type of surgical treatment, lymph node status, use of post-operative adjuvant radiotherapy and concurrent diseases. Demographic and clinical data included: age at diagnosis, parity, presence of intercurrent disease, method of surgical treatment, postoperative adjuvant therapy (chemotherapy or radiotherapy), FIGO surgical stage, grade, depth of invasion, lymph node status and preoperative use of hormones.

The study monitored recurrence of endometrial cancer, death from endometrial cancer and death from intercurrent/overlapping illness. Therefore the study measures were recurrence rate, disease free interval and disease free survival as compared to the estrogen and non-estrogen users. Statistically the patients treated with hormones were compared to their control counterparts by means of a chi-square analysis for discrete variables and with two-tailed t tests for the continuous variables.

Every three months for the first two years all 150 patients were screened by way of a pelvic examination and vaginal Papanicolaou test, after which the screening interval was increased to six months. At a median interval of 83 months, two local recurrences have been documented among the 75 estrogen users, while 11 women from the non-estrogen user group have failed either locally (n=8) or at distant sites (n=3) at a median 69 months follow-up (p=N.S.). The median disease free intervals for the estrogen users (82 months) reaches statistical significance when compared to that for the non-estrogen users (63 months) (p= 0.02). Interestingly, there were no recurrences among the women who gave a history of previous HRT use (49 percent of the estrogen users and 13 percent of the non-estrogen users).

Findings show that estrogen users were less  likely to experience disease recurrence; in fact, a statistically significant survival advantage was afforded this group. The established long-term health benefits of estrogen replacement as it impacts the quality of life seems to outweigh the as yet unfounded theoretical risk of disease recurrence. Appropriate counseling should include a discussion of the available non-hormonal preparations through which some of the benefits of estrogen replacement may be gained.

The Society of Gynecologic Oncologists (SGO) is a professional society of physicians who specialize in gynecologic oncology. SGO is the only U.S. medical organization dedicated to the prevention, detection and cure of female cancers. Gynecologic oncologists are cancer specialists trained in all the effective forms of treatment of gynecologic cancers (surgery, radiation therapy, chemotherapy and experimental treatments) as well as the biology and pathology of gynecologic cancers. The organization is comprised primarily of gynecologic oncologists as well as medical oncologists, radiation therapists, pathologists and basic scientists all of whom have a primary professional commitment to the treatment of women with gynecological malignancies including those of the ovaries, endometrium, uterus, cervix, vagina, vulva and trophoblastic disease. 

WEB SITE: http://www.sgo.org/