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Real-world practice of estrogen therapy after surgery for endometrial cancer: a descriptive study using a Japanese claims database

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Abstract

Background

Estrogen therapy (ET) plays a key role in maintaining the post-surgical quality of life of patients with endometrial cancer. This study investigated the reality of the use of ET after endometrial cancer surgery in Japan.

Methods

Using a healthcare database in Japan, patients who underwent surgery for endometrial cancer between the ages of 40 and 59 years from January 2006 to March 2021 were included. The cumulative prescriptions of ET after endometrial cancer surgeries in patients who had received chemotherapy or radiation therapy (adj-group) and those who did not (non-adj-group) was estimated using the Kaplan–Meier method.

Results

Of the 1475 patients, 115 received ET, among whom transdermal estradiol was initiated in 100 (87.0%) individuals. The cumulative proportions of ET prescription 24 months after surgery [95% confidence intervals (CIs)] were 0.088 [0.072, 0.11] in the non-adj-group and 0.058 [0.040, 0.084] in the adj-group. The cumulative proportion [95% CI] of women who received ET at 24 months after surgeries decreased with increasing age, ranging from 0.29 [0.21, 0.38] in the 40‒44 years old to 0.009 [0.002, 0.034] in the 55‒59 years old women in the non-adj-group and from 0.17 [0.094, 0.31] in the 40‒44 years old to 0 in the 55‒59 years old women in the adj-group.

Conclusion

The present study shows that ET after endometrial cancer surgery may be underused, even in women who underwent surgery between 40 and 44 years of age and without adjuvant therapy.

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Data availability

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References

  1. Nagase S, Ohta T, Takahashi F et al (2021) Annual report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology: Annual patient report for 2017 and annual treatment report for 2012. J Obstet Gynaecol Res 47:1631–1642

    Article  CAS  PubMed  Google Scholar 

  2. Amant F, Moerman P, Neven P et al (2005) Endometrial cancer. The Lancet 366:491–505

    Article  Google Scholar 

  3. Singh P, Oehler MK (2010) Hormone replacement after gynaecological cancer. Maturitas 65:190–197

    Article  CAS  PubMed  Google Scholar 

  4. Del Carmen MG, Rice LW (2017) Management of menopausal symptoms in women with gynecologic cancers. Gynecol Oncol 146:427–435

    Article  PubMed  Google Scholar 

  5. Yamagami W, Mikami M, Nagase S et al (2020) Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms. J Gynecol Oncol 31:e18

    Article  PubMed  Google Scholar 

  6. Parker WH, Broder MS, Chang E et al (2009) Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses’ health study. Obstet Gynecol 113:1027–1037

    Article  PubMed  PubMed Central  Google Scholar 

  7. Pillay OC, Manyonda I (2022) The surgical menopause. Best Pract Res Clin Obstet Gynaecol 81:111–118

    Article  Google Scholar 

  8. Cho HW, Ouh YT, Lee JK et al (2019) Effects of hormone therapy on recurrence in endometrial cancer survivors: a nationwide study using the Korean Health Insurance Review and Assessment Service database. J Gynecol Oncol 30:e51

    Article  PubMed  PubMed Central  Google Scholar 

  9. Barakat RR, Bundy BN, Spirtos NM et al (2006) Randomized double-blind trial of estrogen replacement therapy versus placebo in stage I or II endometrial cancer: a gynecologic oncology group study. J Clin Oncol 24:587–592

    Article  CAS  PubMed  Google Scholar 

  10. Lee RB, Burke TW, Park RC (1990) Estrogen replacement therapy following treatment for stage I endometrial carcinoma. Gynecol Oncol 36:189–191

    Article  CAS  PubMed  Google Scholar 

  11. Chapman JA, DiSaia PJ, Osann K et al (1996) Estrogen replacement in surgical stage I and II endometrial cancer survivors. Am J Obstet Gynecol 175:1195–1200

    Article  CAS  PubMed  Google Scholar 

  12. Practice Bulletin No: 149 (2015) Endometrial cancer. Obstet Gynecol 125:1006–1026

    Article  Google Scholar 

  13. Rees M, Angioli R, Coleman RL et al (2020) European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis. Int J Gynecol Cancer 30:428–433

    Article  PubMed  Google Scholar 

  14. Sinno AK, Pinkerton J, Febbraro T et al (2020) Hormone therapy (HT) in women with gynecologic cancers and in women at high risk for developing a gynecologic cancer: a Society of Gynecologic Oncology (SGO) clinical practice statement: this practice statement has been endorsed by the North American Menopause Society. Gynecol Oncol 157:303–306

    Article  CAS  PubMed  Google Scholar 

  15. Halldorsdottir S, Dahlstrand H, Stålberg K (2018) Gynecologists are afraid of prescribing hormone replacement to endometrial/ovarian cancer survivors despite national guidelines-a survey in Sweden. Ups J Med Sci 123:225–229

    Article  PubMed  PubMed Central  Google Scholar 

  16. Nagai K, Tanaka T, Kodaira N et al (2021) Data resource profile: JMDC claims database sourced from health insurance societies. J Gen Fam Med 22:118–127

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mizuno K, Takeuchi M, Kishimoto Y et al (2019) Indications and outcomes of paediatric tracheotomy: a descriptive study using a Japanese claims database. BMJ Open 9:e031816

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chen S, Yoshida S, Matsumoto R et al (2021) Prescription patterns of antiepileptic drugs for adult patients with newly diagnosed focal epilepsy from 2006 to 2017 in Japan. Epilepsy Res 169:106503

    Article  PubMed  Google Scholar 

  19. Edey KA, Rundle S, Hickey M (2018) Hormone replacement therapy for women previously treated for endometrial cancer. Cochrane Database Syst Rev 5:CD008830

    PubMed  Google Scholar 

  20. Shim SH, Lee SJ, Kim SN (2014) Effects of hormone replacement therapy on the rate of recurrence in endometrial cancer survivors: a meta-analysis. Eur J Cancer 50:1628–1637

    Article  CAS  PubMed  Google Scholar 

  21. Yasui T, Hayashi K, Mizunuma H et al (2012) Factors associated with premature ovarian failure, early menopause and earlier onset of menopause in Japanese women. Maturitas 72:249–255

    Article  PubMed  Google Scholar 

  22. Kaunitz AM, Manson JE (2015) Management of menopausal symptoms. Obstet Gynecol 126:859–876

    Article  PubMed  PubMed Central  Google Scholar 

  23. Yasui T, Ideno Y, Shinozaki H et al (2022) Prevalence of the use of oral contraceptives and hormone replacement therapy in Japan: the Japan Nurses’ Health Study. J Epidemiol 32:117–124

    Article  PubMed  PubMed Central  Google Scholar 

  24. Yokoyama Y, Ito K, Takamatsu K et al (2015) How do Japanese gynecologists view hormone replacement therapy for survivors of endometrial cancer? Japanese Gynecologic Oncology Group (JGOG) survey. Int J Clin Oncol 20:997–1004

    Article  CAS  PubMed  Google Scholar 

  25. Rocca WA, Grossardt BR, de Andrade M et al (2006) Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol 7:821–828

    Article  PubMed  Google Scholar 

  26. Lees B, Hampton JM, Trentham-Dietz A et al (2021) A population-based study of causes of death after endometrial cancer according to major risk factors. Gynecol Oncol 160:655–659

    Article  PubMed  Google Scholar 

  27. Ebina Y, Katabuchi H, Mikami M et al (2016) Japan Society of Gynecologic Oncology guidelines 2013 for the treatment of uterine body neoplasms. Int J Clin Oncol 21:419–434

    Article  PubMed  Google Scholar 

  28. Matsuo K, Cripe JC, Kurnit KC et al (2019) Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer. Gynecol Oncol 155:39–50

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank JMDC Inc. for providing the claims data for the analysis.

Author information

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Yoshihide Inayama, Ken Yamaguchi, Junzo Hamanishi, Miho Egawa & Masaki Mandai

  2. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-Cho, Sakyo-Ku, Kyoto, 606-8501, Japan

    Yoshihide Inayama, Kayoko Mizuno, Masato Takeuchi & Koji Kawakami

Authors
  1. Yoshihide Inayama
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  2. Kayoko Mizuno
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  3. Ken Yamaguchi
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  4. Junzo Hamanishi
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  5. Masato Takeuchi
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  6. Miho Egawa
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  7. Masaki Mandai
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  8. Koji Kawakami
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Corresponding author

Correspondence to Koji Kawakami.

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Conflict of interest

M. T. received consultation fees from Eisai Co., Ltd.; K. K. received research funds from Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Sumitomo Pharma Co., Ltd., Mitsubishi Corporation, and Real World Data Co., Ltd.; consulting fees from LEBER Inc., JMDC Inc., Shin Nippon Biomedical Laboratories Ltd., and Advanced Medical Care Inc.; executive compensation from Cancer Intelligence Care Systems, Inc.; honorarium from Mitsubishi Chemical Holdings Corporation, Mitsubishi Corporation, Pharma Business Academy, and Toppan Inc.

Ethical approval

This study was approved by the Kyoto University Graduate School and Faculty of Medicine Ethics Committee (reference number: R3451). The need to obtain written informed consent from patients was waived, because the data were anonymized.

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Inayama, Y., Mizuno, K., Yamaguchi, K. et al. Real-world practice of estrogen therapy after surgery for endometrial cancer: a descriptive study using a Japanese claims database. Int J Clin Oncol 28, 445–453 (2023). https://doi.org/10.1007/s10147-022-02289-4

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  • DOI: https://doi.org/10.1007/s10147-022-02289-4

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