Gynecological malignancies and hormonal therapies: Clinical management and recommendations

doi:10.5317/wjog.v3.i4.162

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World Journal of Obstetrics and Gynecology

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2218-6220

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World J Obstet Gynecol. Nov 10, 2014; 3(4): 162-170
Published online Nov 10, 2014. doi: 10.5317/wjog.v3.i4.162

Gynecological malignancies and hormonal therapies: Clinical management and recommendations

Anna Myriam Perrone, Federica Pozzati, Donatella Santini, Martina Rossi, Martina Procaccini, Lucia Casalini, Erica Santi, Marco Tesei, Claudio Zamagni, Pierandrea De Iaco

Anna Myriam Perrone, Federica Pozzati, Martina Rossi, Martina Procaccini, Lucia Casalini, Erica Santi, Marco Tesei, Pierandrea De Iaco, Oncologic Gynecology Unit, Sant’Orsola-Malpighi Hospital, 40138 Bologna, Italy

Donatella Santini, Pathology Unit, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy

Claudio Zamagni, Medical Oncology Unit, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy

Author contributions: All authors contributed equally to the work presented in this paper.

Correspondence to: Anna Myriam Perrone, PhD, SSD, Oncologic Gynecology Unit, Sant’Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy. amperrone@libero.it

Telephone: +39-51-6364368 Fax: +39-51-6364392

Received: February 28, 2014
Revised: May 15, 2014
Accepted: September 6, 2014
Published online: November 10, 2014
Processing time: 257 Days and 18.1 Hours

Abstract

Every year in the world a large number of women receive a diagnosis of gynecological cancer and undergo a therapy such as surgery, chemotherapy and radiotherapy to the pelvic region. A large portion of these patients are already in menopause, but for younger patients therapies are responsible of early menopause. The physical and psychological symptoms due to iatrogenic menopause significantly reduce the quality of life; however hormone replacement therapy (HRT) has a high efficacy in reducing menopausal symptoms. The prescription of HRT in patients with story of gynecological cancer is debated because its safety has not been completely proven. The main criticism is based on the theory that the hormone replacement could stimulate growth of residual cancer cells increasing the risk of recurrence.

Keywords: Iatrogenic menopause, Gynecological cancer, Hormone replacement therapy, Risk of recurrence, Climateric symptoms, Cardiovascular benefits, Clinical practice

Core tip: In this paper we analyze the role of hormone replacement therapy (HRT) in patients affected by gynecological neoplasms with iatrogenic menopause symptoms. We have analysed more than 70 articles with the aim to evaluate the possibility of using HRT in different gynaecological malignancies related to stage and grade of the neoplasm. The literature shows that the use of HRT is controversial in type I of endometrial cancer, endometrioid type of ovarian cancer, uterine cervix adenocarcinoma and endometrial stroma and leiomyosarcoma.