Estrogen replacement therapy for ovarian carcinoma survivors : A randomized controlled trial

Surgery for premenopausal and perimenopausal patients with epithelial ovarian carcinoma may often result in significant menopausal symptoms. Physicians may well be reluctant to prescribe, and patients loathe to take, postoperative estrogen replacement therapy because they fear that supplementation may lead to ovarian carcinoma relapse. This randomized prospective study was undertaken to determine whether postoperative estrogen replacement therapy had a negative influence on the disease free interval and overall survival of ovarian carcinoma survivors. Between January 1987 and June 1994, at the time of a routine consultation held 6-8 weeks postoperatively, 130 patients younger than 59 years with invasive epithelial ovarian carcinoma were randomized to continuous oral conjugated equine estrogen (ERT) or to no supplementation (non-ERT). All patients were followed prospectively for a minimum of 48 months. Three patients in the ERT group and 2 in the non-ERT group were lost to follow-up, so 59 and 66 were finally analyzed in their respective groups. Nine patients originally randomized to ERT refused or stopped their supplementation, whereas 5 in the non-ERT commenced taking estrogens. A total of 32 recurrences occurred in the ERT group and 41 in the non-ERT group. The median disease free interval was 34 versus 27 months, respectively, whereas overall survival was 44 versus 34 months, respectively, for the two groups. The differences in disease free interval (P = 0.785) and overall survival (P = 0.354) between the two groups were not statistically significant. Postoperative estrogen replacement therapy did not have a negative influence on the disease free interval and overall survival of ovarian carcinoma survivors.