Postoperative Hormone Replacement Therapy and Survival in Women with Ovarian Cancer

SIMPLE SUMMARY: Previous studies have reported that hormone replacement therapy (HRT) after surgery for ovarian cancer has no significant effect on survival. However, a prospective study and a randomized controlled study showed that HRT administration provided survival benefits. Therefore, this study aimed to investigate the impact of postoperative HRT on survival in women with ovarian cancer using the nationwide cohort study. This cohort study was conducted on 1784 women aged ≤60 and diagnosed with ovarian cancer. Overall survival was significantly greater for women that received HRT than for women that did not after a mean follow-up of 5.6 ± 2.9 years (85.3% vs. 76.6%, respectively). Postoperative HRT may be considered a maintenance therapy in women diagnosed with ovarian cancer at ≤60 years of age. ABSTRACT: The effect of postoperative hormone replacement therapy (HRT) on survival in women with ovarian cancer remains unclear. This study aimed to investigate the impact of postoperative HRT on survival in women with ovarian cancer using the nationwide cohort study. Women aged ≤60 and diagnosed with ovarian cancer that received primary surgery were followed-up for 5.6 ± 2.9 years. Mean ages of women administered HRT (the HRT group; n = 263) or not administered HRT (the control group; n = 1521) were 41.5 ± 8.5 and 41.0 ± 11.4 years, respectively. After adjustment for covariables, OS was significantly greater in the HRT group (HR 0.618; 95% CI 0.414–0.922; p = 0.018). Kaplan–Meier curve analysis showed OS was significantly higher in the HRT group (85.3% vs. 76.6%; p = 0.016). The ratio of women with HRT to women without HRT increased significantly with time (restricted mean survival times for OS, p < 0.001). In addition, OS was significantly greater for those that received HRT for >5 years than for those that received HRT for ≤0.5 years (HR 0.234; 95% CI 0.059–0.936; p = 0.040). Postoperative HRT improved survival among women with ovarian cancer. The impact of HRT on survival increased with time and treatment duration.