J Gynecol Oncol.  2019 Jul;30(4):e51. 10.3802/jgo.2019.30.e51.

Effects of hormone therapy on recurrence in endometrial cancer survivors: a nationwide study using the Korean Health Insurance Review and Assessment Service database

• Cho HW
• Ouh YT
• Lee JK
• Hong JH

• KMID: 2450230
• DOI: http://doi.org/10.3802/jgo.2019.30.e51

Abstract

OBJECTIVE
The aim of this study was to verify the effects of hormone therapy (HT) on recurrence in endometrial cancer (EC) survivors using the Korean Health Insurance Review and Assessment Service (HIRA) database.
METHODS
Using the HIRA claims database, we identified all Korean women who were newly diagnosed with EC and underwent surgical staging between 2010 and 2013. Patient characteristics such as age, HT exposure, lymphadenectomy, and adjuvant therapy were evaluated. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the recurrence of EC.
RESULTS
The mean follow-up time of all 5,667 eligible patients was 47.5 months. Of these, 847 (14.9%) received HT. Recurrence was seen in 446 (7.8%) patients. Univariate analysis revealed an increased recurrence rate in patients older than 50 years (HR=2.05; 95% CI=1.62-2.63), patients with high-risk EC (HR=24.51; 95% CI=18.63-32.35), and patients who underwent lymphadenectomy (HR=1.52; 95% CI=1.21-2.03), and a reduced recurrence rate in patients who received HT (HR=0.62; 95% CI=0.46-0.83). Multivariate analysis confirmed the significant increase in recurrence in patients older than 50 years (HR=1.47; 95% CI=1.14-1.89) and in patients with high-risk EC (HR=23.90; 95% CI=18.12-31.51). HT did not increase the recurrence rate of EC (HR=0.81; 95% CI=0.31-2.10).
CONCLUSION
This study demonstrates that HT does not increase disease recurrence in EC survivors, despite lack of data that could affect the outcome.

Keyword

Hormone Replacement Therapy; Endometrial Cancer; Recurrence

MeSH Terms

Endometrial Neoplasms*
Female
Follow-Up Studies
Hormone Replacement Therapy
Humans
Insurance, Health*
Lymph Node Excision
Multivariate Analysis
Proportional Hazards Models
Recurrence*
Survivors*

Figure

• 

  Fig. 1. A flowchart of the study design. EC, endometrial cancer; HT, hormone therapy; KNHI, Korean National Health Insurance.

Reference

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