Adjuvant progestagen therapy for the treatment of endometrial cancer: review and meta-analyses of published randomised controlled trials.
OBJECTIVE
To assess the efficacy of adjuvant progestagen therapy for the treatment of endometrial cancer.


METHODS
Computerised literature review by MEDLINE backed up by a manual search of 16 journals published before January 1995, to identify relevant published randomised controlled trials. Trials were classified according to methodological quality criteria. Odds ratios and 95% confidence intervals (CIs) were calculated where data allowed.


METHODS
Institute of Epidemiology and Health Service Research, University of Leeds.


METHODS
Patients presenting with endometrial cancer.


METHODS
Adjuvant progestagen therapy.


RESULTS
Death (overall, cancer related and intercurrent) and relapse.


RESULTS
Six randomised controlled trials comparing adjuvant progestagen with no adjuvant therapy in the treatment of endometrial cancer were identified in the literature prior to January, 1995. Three trials had an acceptable method of randomisation. Meta-analysis demonstrated that overall survival was not improved by adjuvant progestagen therapy and may even have been adversely affected. Furthermore, this treatment was not associated with any reduction in relapse or death from endometrial cancer.


CONCLUSIONS
Current evidence does not support use of adjuvant progestagen therapy in the primary treatment of endometrial cancer.
Martin-Hirsch
P L
PL
Institute of Epidemiology and Health Service Research, University of Leeds, UK.
Lilford
R J
RJ
Jarvis
G J
GJ
D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D015337:Multicenter Studies as Topic; D011372:Progestins / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome
D011372:Progestins