[Clinical significance of adjuvant endocrine therapy in treatment of endometrial carcinoma: study of 171 patients].
OBJECTIVE
To study the effectiveness of adjuvant endocrine therapy on the prognosis of endometrial carcinoma and to analyze the influence of progesterone receptor on the curative effect of adjuvant endocrine therapy.


METHODS
A retrospective study was carried out on 171 patients of endometrial carcinoma with similar pathological examination. 82 of the 171 patients with endometrial carcinoma (48.0%), aged (57 +/- 9) years, underwent endocrine therapy, mainly by progesterone (245 +/- 51) mg/d for (1.3 +/- 0.9) years. 55 cases (67.1%), aged (57 +/- 10) years, underwent endocrine therapy for more-than-one-year (more-than-one-year subgroup), and 27 cases (32.9%), aged (59 +/- 9) years, underwent endocrine therapy for less-than-one-year (less-than-one-year subgroup). 24 of the 82 patients (29.3%) underwent adjuvant radiotherapy. 89 of the 171 patients (52.0%), aged (57 +/- 11) years, were in the control group 31 of the 89 patients in the control group (34.8%) underwent adjuvant radiotherapy, and 39 patients (43.8%) underwent adjuvant endocrine therapy. Follow-up was performed by correspondence, phone call, or outpatient department visit for 3 approximately 4 years.


RESULTS
The rate of recurrence and/or metastasis of the endocrine therapy group was 13.4%, not significantly different from that of the control group (23.6%, P > 0.05); the death rate of the endocrine therapy group was 12.2%, not significantly different from that of the control group (20.2%, P > 0.05). The rate of recurrence and/or metastasis of the less- than-one-year subgroup was 25.9%, significantly higher than that of the more-than-one-year subgroup (7.3%, P = 0.012); the death rate of the less- than-one-year subgroup was 22.2%, significantly higher than that of the more-than-one-year subgroup (7.3%, P = 0.036). Cox regression showed that stage, the operation, tumor cell differentiation, and duration of endocrine therapy significantly affected the recurrence/metastasis remarkably (OR = 5.199, OR = 0.507, OR = 1.796, OR = 0.538) and the death rater (OR = 5.488, OR = 0.482, OR = 1.516, OR = 0.547). The rate of recurrence/metastasis of the endocrine therapy group patients with positive progesterone receptor was 4.7%, significantly higher than that of the patients with negative progesterone receptor (26.7%, P = 0.034).


CONCLUSIONS
The prognosis of endometrial carcinoma patients can be improved with adjuvant endocrine therapy, especially for those with positive progesterone receptor. Endocrine therapy should be continued no less than 1 year.
Wang
Zhi-qi
ZQ
Center of Gynecologic Oncology, Peking University People's Hospital, Beijing 100044, China.
Wang
Jian-liu
JL
Guo
Jian
J
Wei
Li-hui
LH
D000368:Aged; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011372:Progestins / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
D011372:Progestins