ARE THERE ANY ARGUMENTS TO PROSCRIBE HORM ONE REPLACEMENT THERAPY IN WOMEN TREATED FOR OVARIAN ADENOCARCINOMA

The hormonal status of 95% of the women treated for epithelial ovarian carcinoma is menopausal either naturally or after treatment This rais es the important question of the hormonal replacement therapy (HRT) am ong these patients. Several retrospective studies have explored the po tentiel positive or negative influence of HRT on the genesis of ovaria n adenocarcinoma. Although somehow contradictory, these studies taken all together fail to show any favouring nor protective role of HRT. In vitro, estrogens have been shown to induce the proliferation of ovari an cancer cell lines. On the opposite, progesterone and antiestrogens have antiproliferative effects. Both types of effects are mediated by intracellular steroid hormone receptors (ER, PgR). Although high dose progesterone derivatives and antiestrogens have been shown to obtain t herapeutic responses in patients carrying advanced ovarian carcinoma, response rates were usually less than 20%, and no clinico-biological c orrelation (with ER, PgR status) could be demonstrated. There is there fore no evidence for a clinical significance of the presence of hormon al receptors in these tumors. A single retrospective study explored th e possible influence of HRT on the prognosis of patients treated for o varian carcinoma, and did not demonstrate any deleterious effect. This review of recent epidemiological, biological and clinical data fails to find any argument against the prescription of HRT in patients treat ed for ovarian adenocarcinoma, in the absence of other contra-indicati ons.