This review summarizes information regarding
estrogen therapy (ET) and
hormone therapy (HT) for women with
endometrial cancer as well as other gynecologic
malignancies. The cumulative experience from 4 case-control studies consists of 537 affected women. Of the 228 patients who received
estrogen therapy, 3.5% developed recurrences as opposed to 16.5% among the 309 women receiving no
therapy. Administration of ET at an early stage of disease is therefore appropriate if a few conditions are fulfilled. The impact of
estrogen on other gynecologic
malignancies is not as evident. As to
ovarian cancer, the information on
hormone employment is scantier and derives mainly from statistical analysis of data on healthy users of
estrogen alone or combined with
progestin. Several age-matched, case-control studies and 4 meta-analyses disclosed a higher rate, though not significant, of the later development of
ovarian cancer among
hormone users. Focusing on patients with disease, 2 trials conducted so far have failed to demonstrate any change in survival or mortality from ET or HT. It is agreed, however, that the histologic type of the
tumor is an important factor to consider prior to the initiation of such
therapy. The current literature permits ET in most cases of
ovarian cancer, but further studies are needed to clearly delineate specific
contraindications. Utilizing
estrogen compounds has no bearing on risks of later developing
squamous cell carcinoma of the cervix, or tubal, vulvar or
vaginal cancer. Those conditions do not seem to contraindicate later employment of ET or HT. A previous history of cervical
adenocarcinoma, however, definitely prohibits the use of these hormonal regimens.