Adjuvant medroxyprogesterone acetate in high-risk endometrial cancer

Abstract

COSA-NZ-UK Endometrial Cancer Study Groups. Adjuvant medroxyprogesterone acetate in high-risk endometrial cancer.Int J Gynecol Cancer 1998;8: 387–391. One thousand twelve patients with high-risk endometrial cancer (grade 3 endometrioid, adenosquamous, clear cell or papillary serous cancer, any tumor >1/3 invasive or involving cervix or adnexa) were randomized to receive adjuvant medroxyprogesterone acetate (MPA) 200 mg b.d., or no hormonal therapy following surgery, for at least three years. When all patients were analyzed, there were significantly more relapses in patients who did not receive MPA (P < 0.05), but there were no differences in survival. A secondary analysis, excluding those 112 patients considered ineligible following central pathology review, was undertaken; patients who received MPA had a significantly longer disease-free interval (P= 0.03) and survival (P= 0.03) than those who did not. Fifty-nine of the 96 women in the control group were given MPA on relapse. Median survival in this group was 10 months compared to four months in those not given hormonal therapy. Steroid receptor status had no influence on outcome in either arm.