Progestagens for endometrial cancer (Cochrane Review)

A substantive amendment to this systematic review was last made on 29 June 1999. Cochrane reviews are regularly checked and updated if necessary.

Background: Endometrial cancer is the most common genital tract carcinoma in many western countries, with the majority (approximately 75%) of women presenting with stage 1 disease. The overall unadjusted five year survival for stage 1 disease is relatively high at 75% , but women with poor prognostic factors within stage 1 can have a survival expectancy as low as 26%. Adjuvant progestagen therapy has been advocated following primary surgery to reduce the risk of recurrence of disease. We have reviewed the effectiveness of this therapy.

Objectives: Progestagen therapy following primary surgery for endometrial cancer has been advocated to reduce the risk of recurrence. The objective of this review was to assess the effect of adjuvant progestagen therapy in endometrial cancer.

Search strategy: We searched the Cochrane Gynaecological Cancer Group trials register and MEDLINE up to May 1999.

Selection criteria: Randomised trials of progestagen therapy in women who have had surgery for endometrial cancer.

Data collection and analysis: Trial quality was assessed and two reviewers abstracted data independently.

Main results: Six trials involving 4351 women were identified. Three trials included women with stage one disease only, whereas three included women with more advanced disease. Based on five trials, overall survival was not improved by adjuvant progestagen therapy (OR 1.05, 95% CI 0.88 to 1.24). Endometrial cancer deaths and relapse of disease appears to be reduced by progestagen therapy OR 0.88 95% CI (0.71-1.1) and 0.81 95% CI (0.65-1.01) respectively. However, non-endometrial cancer related deaths were more common in women treated with progestagens OR 1.33 (1.02-1.73).

Reviewers' conclusions: Current evidence does not support the use of adjuvant progestagen therapy in the primary treatment of endometrial cancer.

Citation: Martin-Hirsch P L, Jarvis G, Kitchener H, Lilford R. Progestagens for endometrial cancer (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

---

This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

The Cochrane Library is designed and produced by Update Software Ltd.

Update Software Ltd, Summertown Pavilion, Middle Way, Oxford OX2 7LG, UK
(Tel:+44 1865 513902; Fax:+44 1865 516918)

File Reference: AB001040.htm