Impact of menopausal hormone therapy on the development and progression of cervical and endometrial cancers
Antitumor therapy for malignant diseases of the reproductive system is often accompanied by the development of induced menopause. Studying the possibility of safely prescribing menopausal hormone therapy (MHT) in this group of patients is an urgent task, since most patients have to deal with the consequences of estrogen deficiency states after antitumor therapy for many years. The review analyzes the available information on the rate of progression/recurrence of the neoplastic process in cervical cancer/endometrial cancer (CC/EC) survivors during MHT. Articles were sought in accordance with the recommendations of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) presented in PubMed and SCOPUS. The use of MHT was evaluated in two ways: 1) as a risk factor for CC/EC in women without a history of this pathology and 2) as a risk factor for CC/EC recurrence/progression. Analyzing the available publications revealed no reliable evidence for the negative effect of MHT on the outcomes of CC/EC. To prescribe MHT after favorable completion of antitumor therapy in patients with a history of squamous cell CC has long been a routine practice. With hormone-dependent СC/EC in young women with induced menopause, the possibility of using MHT should be resolved in favor of the existing advantages (in reducing the risk of age-associated pathology and in improving the quality of life) and assessing the corresponding risks.Yakushevskaya O.V., Babaeva N.A., Yureneva S.V., Ashrafyan L.A.
Conclusion: The possibility of prescribing MHT to patients with a history of cancer should be discussed within the framework of a council of physicians, such as a gynecological oncologist, a chemotherapist, and an obstetrician/gynecologist. Further prospective and randomized studies are needed to fully evaluate the impact of MHT on oncological outcomes in CC/EC survivors.
Keywords
cervical cancer
endometrial cancer
menopausal hormone therapy
iatrogenic menopause
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Received 13.05.2022
Accepted 15.07.2022
About the Authors
Oksana V. Yakushevskaya, Ph.D., Researcher at the Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)531-44-44, aluckyone777@gmail.com, https://orcid.org/0000-0002-7430-1207,117997, Russia, Moscow, Ac. Oparina str., 4.
Nataliya A. Babaeva, Dr. Med. Sci., Oncologist, Oncological Department of Surgical Methods of Treatment, Leading Researcher, Institute of Oncogynecology and Mammology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, natbabaeva@yandex.ru, natbabaeva@yandex.ru, https://orcid.org/0000-0002-4654-9512, 117997, Russia, Moscow, Ac. Oparina str., 4.
Svetlana V. Yureneva, Dr. Med. Sci., Leading Researcher of the Department of Gynecological Endocrinology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, syureneva@gmail.com, https://orcid.org/0000-0003-2864-066X, 117997, Russia, Moscow, Ac. Oparina str., 4.
Levon A. Ashrafyan, Academician of the RAS, Dr. Med. Sci., Professor, Director of the Institute of Oncogynecology and Mammology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, levaa2004@yahoo.com, https://orcid.org/0000-0001-6396-4948,
117997, Russia, Moscow, Akademika Oparina str., 4.
Authors' contributions: Yakushevskaya O.V. – obtaining data for analysis, analysis of the findings, writing the article;
Yureneva S.V. – obtaining data for analysis, analysis of the article written; Babaeva N.A., Ashrafyan L.A. – analysis of the article written.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The article has been written without financial support.
For citation: Yakushevskaya O.V., Babaeva N.A., Yureneva S.V., Ashrafyan L.A.
Impact of menopausal hormone therapy on the development and
progression of cervical and endometrial cancers.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 8: 30-35 (in Russian)
https://dx.doi.org/10.18565/aig.2022.8.30-35
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