Prediagnostic use of menopausal hormone therapy and long-term survival of localized epithelial ovarian cancer: The Extreme study

Int J Cancer. 2024 Jul 1;155(1):19-26. doi: 10.1002/ijc.34936. Epub 2024 Mar 26.

Abstract

Use of menopausal hormone therapy (MHT) prior to an epithelial ovarian cancer (EOC) diagnosis has been suggested to be associated with improved survival. In a recent nationwide cohort study, we found that prediagnostic long-term MHT use, especially estrogen therapy (ET), was associated with improved long-term survival in women with nonlocalized EOC. Our aim was to investigate the influence of prediagnostic MHT use on long-term survival among women with localized EOC in the same nationwide study. Our study cohort comprised all women aged 50 years or older with an EOC diagnosis in Denmark 2000-2014 (n = 2097) identified from the Extreme study. We collected information on usage of systemic ET and estrogen plus progestin therapy (EPT) from the Danish National Prescription Registry. By using pseudo-values, 5- and 10-year absolute and relative survival probabilities were estimated with 95% confidence intervals (CIs) while adjusting for histology, comorbidity, and income. Relative survival probabilities >1 indicate better survival. The 5-year absolute survival probabilities were 61% and 56%, respectively, among women who were nonusers and users of prediagnostic MHT, whereas these numbers were 46% and 41%, respectively, regarding 10-year survival. Use of MHT was not significantly associated with an improved 5- or 10-year survival in women with localized EOC (5-year relative survival probability = 0.95, 95% CI: 0.89-1.02; 10-year relative survival probability = 0.92, 95% CI: 0.84-1.02). Similar findings were seen for systemic ET or EPT use. Our findings do not suggest a positive benefit from prediagnostic MHT use on long-term survival of localized EOC.

Keywords: long‐term survival; menopausal hormone therapy; ovarian cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Ovarian Epithelial* / drug therapy
  • Carcinoma, Ovarian Epithelial* / mortality
  • Carcinoma, Ovarian Epithelial* / pathology
  • Cohort Studies
  • Denmark / epidemiology
  • Estrogen Replacement Therapy / adverse effects
  • Estrogen Replacement Therapy / methods
  • Estrogens / administration & dosage
  • Female
  • Humans
  • Menopause
  • Middle Aged
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / mortality
  • Ovarian Neoplasms* / pathology
  • Progestins / administration & dosage
  • Progestins / therapeutic use
  • Registries

Substances

  • Estrogens
  • Progestins

Grants and funding