Effect of long-term hormone replacement therapy on the bone in ovariectomized women with cancer.
OBJECTIVE
To evaluate longitudinally the effectiveness of long-term hormone replacement therapy (HRT) in preserving the bone mineral density (BMD) over a 5-year period in ovariectomized patients treated for gynecologic malignancies.


METHODS
A total of 70 pre-menopausal women ovariectomized for gynecologic malignancies at our hospital were divided non-randomly into two groups: HRT (+) group (n = 59) and HRT (-) group (n = 11). HRT was administered in a sequential regimen of 0.625-1.25 mg conjugated estrogen for 24 days and 5-10 mg medroxyprogesterone acetate for 10 days.


RESULTS
The BMD of the lumbar vertebrae decreased significantly in the HRT (-) group (pre-operative BMD was 91.8%, 91.0% and 91.3% at 1, 2 and 3 years post-ovariectomy), but no decrease in the BMD was observed in the HRT (+) group (pre-operative BMD was 98.4%, 99.0%, 99.4%, 98.8% and 98.7% at 1, 2, 3, 4 and 5 years post-ovariectomy); the difference in BMD between the two groups was statistically significant (P < 0.01). Serum alkaline phosphatase levels were significantly lower in the HRT (+) group than in the HRT (-) group (P < 0.01). There were four recurrences of cancer in the HRT (+) group.


CONCLUSIONS
HRT appeared to have beneficial effects on bone metabolism by maintaining BMD for 5 years in ovariectomized patients for gynecologic malignancies.
Kurabayashi
T
T
Department of Obstetrics and Gynecology, Niigata University School of Medicine, Japan. takumi@med.niigata-u.ac.jp
Yahata
T
T
Honda
A
A
Tomita
M
M
Yasuda
M
M
Tanaka
T
T
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015519:Bone Density; D016889:Endometrial Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D015914:Estrogen Replacement Therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D010052:Ovariectomy; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000503:physiopathology / Q000601:surgery
D000469:Alkaline Phosphatase