The role of hormonal therapy in patients with uterine carcinoma

Czech version

Authors: P. Vinklerová ¹; Luboš Minář ¹; Michal Felsinger ¹; Matěj Anton ¹; P. Ventruba ¹; Markéta Bednaříková ²; J. Hausnerová ³; E. Jandáková ³; M. Číhalová ³; Vít Weinberger ¹
Authors‘ workplace: Gynekologicko-porodnická klinika LF MU a FN, Brno, npřednosta prof. MUDr. P. Ventruba, DrSc., MBA ¹; Interní hematologická a onkologická klinika LF MU a FN, Brno, přednosta prof. MUDr. J. Mayer, CSc. ²; Ústav patologie LF MU a FN, Brno, přednosta doc. MUDr. L. Křen, Ph. D. ³
Published in: Ceska Gynekol 2018; 83(4): 263-270
Category:

Overview

Objective: The aim of the study was to describe the role of hormonal therapy in the treatment of malignant uterine tumors, indications, the effect of the treatment and to verify its safety in our study cohort. We also present an overview of recent studies on that topic.

Design: Unicentric retrospective observational study and review of recent literature.

Setting: Department of Obstetrics and Gynecology, Masaryk University, University Hospital Brno.

Methods: The results of recent relevant studies and reviews published in English until December 2017 were used for the review. The publications were searched using the PubMed server. All patients diagnosed in our oncogynecological center between 2010 and 2016 and who were treated hormonally – either in primary therapy or in relapse settings, were included in our study. We were interested in age, BMI, stage of disease, histological type and grade of tumor, occurrence of adverse effects, duration of survival, reasons for choosing hormonal therapy. Medroxyprogesterone-acetate or megestrol-acetate was used in the treatment.

Results: Between 2010 and 2016, 415 malignant tumors of the uterus were diagnosed in our oncology center. Recurrence of the disease occurred in 31 patients (8%), on average 16 months after primary treatment. Primary hormonal therapy was used in only 19 patients (5%), mostly because of contraindications of another treatment due to high age, comorbidities or obesity. Median age of patients was 83 years, mean BMI 41, median survival of patients who died was 8 months. Five patients (16%) were treated hormonally for the recurrence. Median survival from diagnosis of recurrence was 20 months. One patient (4%) experienced partial pulmonary embolism.

Conclusion: Hormonal therapy plays an irreplaceable role in uterine cancer patients, especially in primary non-operable patients, in treatment of a relapse, or in a fertility-sparing procedure. This treatment option is safe, with minimal adverse effects.

Keywords: endometrial carcinoma, hormone therapy, medroxyprogesterone-acetate, megestrol-acetate, palliative therapy, fertility-sparing treatment

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