Hormone replacement therapy after invasive ovarian serous cystadenocarcinoma treatment: the effect on survival.

AIM: Our report deals with the presumed influence of hormone replacement therapy (HRT) on the survival of patients with invasive ovarian serous cystadenocarcinoma. MATERIALS AND METHODS: We selected a group of 24 patients with the diagnosis of invasive ovarian serous cystadenocarcinoma who were treated with HRT after primary surgical treatment. Each patient from the selected group was compared with two patients from the control group with the same diagnosis who did not receive HRT. The matching criteria were the age at the time of the diagnosis, year of the diagnosis, stage of the disease, differentiation, residual tumor after first operation, and disease-free interval until receiving HRT. We used Cox regression to calculate odds ratios as estimates of the effect of HRT on overall survival in the patients with invasive ovarian serous cystadenocarcinoma who did or did not receive HRT after diagnosis. RESULTS: HRT was started an average of 21 months (range, 1-25 months) after diagnosis, and lasted for an average of 24 months (range, 1-70 months). After taking into account the effects of other known prognostic factors (the age at the time of the diagnosis, stage of the disease, differentiation, type of operation, residual tumour before the first operation), the estimated risk of death in patients with invasive ovarian serous cystadenocarcinoma who received HRT was 0.90 (odds ratio = 0.90; 95% confidence interval, 0.24-5.08). CONCLUSION: The results of our small study are only preliminary and suggest that HRT does not have a pronounced effect on survival. A single center can scarcely obtain a sufficient number of such a specific group of cancer patients; therefore, the collaboration of different institutions, preferably in a randomized, controlled trial, is needed for more reliable results.

A case-control study of Hodgkin's disease and pregnancy.

To evaluate the role of pregnancy in the pathogenesis and clinical course of Hodgkin's disease (HD), we studied a series of 192 female patients aged 17-50 years at the time of diagnosis, and 496 healthy controls matched by residence and year of birth. Cases showed a marginally significant excess for the father having a high level of education, and more families were classified as white-collar workers than as industrial workers. No significant differences between cases and controls were found in other parameters describing the family and living conditions in childhood. Before the age when cases were diagnosed, 35.4% of cases and 34.7% of their controls were nulliparous. Among the cases, the mean age at first delivery was 22.4 years, with a total of 201 children (average: 1.05 per case) born before diagnosis; for the controls, the corresponding figures were 22.2 years and 573 children (average: 1.15). Within the first 6 months after the last delivery, HD was diagnosed in 12 of 124 parous cases (9.7%); for controls, the corresponding number is 18 out of 324 (5.6%). A marginally significant negative trend (P = 0.07) in odds ratios is seen with increasing duration of this interval. We conclude that our study could not confirm previous reports of a protective effect of pregnancy for the risk of HD. On the other hand, marked physiological changes in the period of puerperium may accelerate the expression of HD.