Ruiz MP, et al. – This article was written with the objective to explore the utilization and safety of progestational therapy in young women with endometrial cancer. It was concluded that the progestational therapy utilization was increased in this study. Its utilization was related to decreased survival, especially in women with stage IB tumors.

Methods

• They identified women ≤ 49 years of age with stage I endometrial cancer in the National Cancer Database from 2004–2014.
• In this study, women treated with hormonal therapy with or without hysterectomy were compared to women treated with hysterectomy.
• Overall survival was analyzed utilizing proportional hazards models after propensity score weighting.

Results

• In this study, they identified a total of 23,231 patients.
• Out of these 23,231 patients, 872 (3.8%) women treated with hormonal therapy were included in this study.
• 2.4% (95% CI, 1.8–3.3%) was the utilization of hormonal therapy in 2004 and increased over time to 5.9% (95% CI, 5.0–6.9%) by 2014 (P<0.0001).
• Utilization of hormonal therapy reduced with older age, higher sub–stage and increasing grade.
• Black women will probably receive hormonal therapy while Medicaid recipients were less likely to receive hormonal therapy.
• The five–year survival for patients treated with hormonal therapy was 96.4% (95% CI, 94.3–98.0%) compared to 97.2% (95% CI, 96.9–97.4%) for hysterectomy.
• In a multivariable model, women treated with hormonal therapy were 92% (HR=1.92; 95% CI, 1.15–3.19) more likely to die compared to women who underwent primary hysterectomy.
• When stratified by stage, hormonal therapy was related to increased mortality in women with stage IB and I–not otherwise specified (INOS) tumors but not for stage IA neoplasms.