Impact of Hormone Replacement Therapy on the Overall Survival and Progression Free Survival of Ovarian Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Frequently, patients treated for Ovarian Cancer (OC) undergo menopause with subsequent symptoms. This review scrutinised the impact of Hormone Replacement Therapy (HRT) on the Overall Survival (OS) and Progression-Free Survival (PFS) of patients diagnosed with OC. Methods: A systematic literature search was conducted in the most popular English databases. Inclusion and exclusion criteria were applied to select publications that evaluate OS and PFS in these patients. End-point analysis targeted values of log(HR) and its Standard Error (SE). Results: Up to 1 September 2022, 11 studies were included in the qualitative synthesis. Eight publications, totalling 4191 patients, were included in the meta-analyses. Eight studies were considered for the OS analysis and pooled an HR of 0.66 with respective 95% CI between 0.57 and 0.76, with a p-value < 0.00001 at a Z value of 5.7, in favour of the HRT group. Results for PFS showed an overall HR of 0.73 in favour of the HRT group; CI between 0.57 and 0.95, p = 0.02 at a Z value of 2.36. Further subgroup analyses highlighted the non-inferiority of this treatment. Conclusions: Patients treated for OC that receive HRT for menopausal symptoms after various treatments appeared to have better OS than never-users.

Sexual Health in Women Affected by Gynecologic or Breast Cancer

“…Although it is difficult to synthesize the existing literature due to heterogeneity in study designs and methodologies among studies, two meta-analyses resulted in the overarching consensus that HT use after epithelial ovarian cancer treatment did not significantly increase the risk of recurrence or affect overall survival when compared with placebo in patients with epithelial ovarian cancer. 81,91,92 Unfortunately the data are even more limited for germ cell, sex cord stromal, and borderline tumors. Germ cell tumors commonly affect girls and young women between age 10 and 30 years.…”

Comparative study on the mutation spectrum of L‐MYC and C‐MYC genes of blood cfDNA in patients with ovarian cancer and healthy females

“…1 Due to its asymptomatic nature, unclear sign and symptoms, majority of patients are diagnosed at an advanced stage. 2,3 Increasing evidences report that the family history of OC is associated with increased risk of this disease. 4 According to a global research published by the International Federation of Gynecology and Obstetrics (FIGO), the prevalence of OC is increasing in younger women, although various investigations have outlined that these young women are interested in preserving their fertility in addition to treating this cancer but it is difficult to sustain the reproductive function because the ovary is site of the primary cancer.…”

“…4 According to a global research published by the International Federation of Gynecology and Obstetrics (FIGO), the prevalence of OC is increasing in younger women, although various investigations have outlined that these young women are interested in preserving their fertility in addition to treating this cancer but it is difficult to sustain the reproductive function because the ovary is site of the primary cancer. 3,5 Due to the lack of specificity and sensitivity of CA125 marker, widely used for the detection of this fatal disease, highly efficient, specific and sensitive marker is prerequisite in reducing both cancer incidence as well as mortality. 6,7 The biological mechanism for transforming normal cells into cancerous ones remains elusive, although increasing evidence signifies that this transformation likely involves the accumulation of genetic lesions in at least three classes of genes, namely proto-oncogenes, tumor suppressor genes, and mutator genes.…”

“…Ovarian cancer (OC), the eighth most common cancer worldwide is the most mystifying gynecological malignancy among the females 1 . Due to its asymptomatic nature, unclear sign and symptoms, majority of patients are diagnosed at an advanced stage 2,3 . Increasing evidences report that the family history of OC is associated with increased risk of this disease 4 .…”

“…Increasing evidences report that the family history of OC is associated with increased risk of this disease 4 . According to a global research published by the International Federation of Gynecology and Obstetrics (FIGO), the prevalence of OC is increasing in younger women, although various investigations have outlined that these young women are interested in preserving their fertility in addition to treating this cancer but it is difficult to sustain the reproductive function because the ovary is site of the primary cancer 3,5 . Due to the lack of specificity and sensitivity of CA125 marker, widely used for the detection of this fatal disease, highly efficient, specific and sensitive marker is prerequisite in reducing both cancer incidence as well as mortality 6,7 …”