Impact of menopausal hormone therapy on the development and progression of cervical and endometrial cancers


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Abstract

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 CC/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. 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.

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About the authors

Oksana V. Yakushevskaya

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: aluckyone777@gmail.com
Ph.D., Researcher at the Department of Gynecological Endocrinology

Nataliya A. Babaeva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: natbabaeva@yandex.ru
Dr. Med. Sci., Oncologist, Oncological Department of Surgical Methods of Treatment, Leading Researcher, Institute of Oncogynecology and Mammology

Svetlana V. Yureneva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: syureneva@gmail.com
Dr. Med. Sci., Leading Researcher of the Department of Gynecological Endocrinology

Levon A. Ashrafyan

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: levaa2004@yahoo.com
Academician of the RAS, Dr. Med. Sci., Professor, Director of the Institute of Oncogynecology and Mammology

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