title: Adjuvant Hormone Therapy May Improve Survival in Epithelial Ovarian Cancer: Results of the AHT Randomized Trial.
abstract: OBJECTIVE
  To assess the effects of adjuvant hormone therapy (AHT) on survival and disease outcome in women with epithelial ovarian cancer.
  
  
  METHODS
  Participants were premenopausal and postmenopausal women who had been diagnosed with epithelial ovarian cancer (any International Federation of Gynecology and Obstetrics stage) 9 or fewer months previously. Ineligible patients included those with deliberately preserved ovarian function, with a history of a hormone-dependent malignancy, or with any contraindications to hormone-replacement therapy. Patients were centrally randomly assigned in a 1:1 ratio to either AHT for 5 years after random assignment or no AHT (control). Main outcome measures were overall survival (OS), defined as time from random assignment to death (any cause), and relapse-free survival, defined as time from random assignment to relapse or death (any cause). Patients who continued, alive and relapse free, were censored at their last known follow-up.
  
  
  RESULTS
  A total of 150 patients (n = 75, AHT; n = 75, control) were randomly assigned from 1990 to 1995 from 19 centers in the United Kingdom, Spain, and Hungary; all patients were included in intention-to-treat analyses. The median follow-up in alive patients is currently 19.1 years. Of the 75 patients with AHT, 53 (71%) have died compared with 68 (91%) of 75 patients in the control group. OS was significantly improved in patients who were receiving AHT (hazard ratio, 0.63; 95% CI, 0.44 to 0.90; P = .011). A similar effect was seen for relapse-free survival (hazard ratio, 0.67; 95% CI, 0.47 to 0.97; P = .032). Effects remained after adjustment for known prognostic factors.
  
  
  CONCLUSIONS
  These results show that women who have severe menopausal symptoms after ovarian cancer treatment can safely take hormone-replacement therapy, and this may, in fact, infer benefits in terms of OS in addition to known advantages in terms of quality of life.
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary. ros.eeles@icr.ac.uk.
authors.forename: Rosalind A
authors.initials: RA
authors.lastname: Eeles
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: James P
authors.initials: JP
authors.lastname: Morden
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Martin
authors.initials: M
authors.lastname: Gore
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Janine
authors.initials: J
authors.lastname: Mansi
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: John
authors.initials: J
authors.lastname: Glees
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Miklos
authors.initials: M
authors.lastname: Wenczl
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Christopher
authors.initials: C
authors.lastname: Williams
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Henry
authors.initials: H
authors.lastname: Kitchener
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Richard
authors.initials: R
authors.lastname: Osborne
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: David
authors.initials: D
authors.lastname: Guthrie
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Harper
authors.affiliation: Rosalind A. Eeles, James P. Morden, and Judith M. Bliss, The Institute of Cancer Research; Martin Gore, The Royal Marsden Hospital; Janine Mansi, St George's Hospital; Peter Harper, Guy's Hospital, London; John Glees, Epsom Hospital, Epsom, and The Royal Marsden Hospital, Sutton; Christopher Williams, Southampton General Hospital, Southampton; Henry Kitchener, Aberdeen Royal Infirmary, Aberdeen; Richard Osborne, Addenbrookes Hospital, Cambridge; David Guthrie, Derbyshire Royal Infirmary, Derby, United Kingdom; and Miklos Wenczl, Markusovszky Teaching Hospital, Szombathely, Hungary.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Bliss
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D006814:Hungary; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy*; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D011788:Quality of Life; D013030:Spain; D016896:Treatment Outcome; D006113:United Kingdom; D016903:Drug Monitoring
chemical_list: D018931:Antineoplastic Agents, Hormonal