Hormone replacement therapy and outcome for women with non-small cell lung cancer: can an association be confirmed?

Omodele Ayeni, Andrew Robinson


ABSTRACT BACKGROUND: A recent report suggested that women who had been taking hormone replacement therapy (HRT) had significantly decreased survival after a lung cancer diagnosis. Given the large cohort of women who have received hormone replacement therapy, it is important to try to confirm this association. METHODS: Female patients diagnosed with lung cancer between January 1999 and December 2003 were reviewed for age at diagnosis, stage, treatment, smoking history, HRT, performance status, weight loss, age at menopause, and overall survival. Patients were excluded if they had small cell lung cancer, unknown primary cancer, or had previous or synchronous non-lung, non-skin, cancers. Statistics were performed using Chi-Squared tests for categorical variables, while the Kaplan-Meier method and Cox-Regression models were used for univariate and multivariate analysis of overall survival. RESULTS: Of 397 patients, the majority (68%) were stage 3 or 4. There were very few never smokers (5%). Twenty-nine percent of patients had prior or current HRT, with no effect on overall survival. Median survival was 13 months in the non-HRT group and 14 months in the HRT group. Significant factors predicting for overall survival include performance status, stage, and weight loss. CONCLUSION Stage, performance status, and weight loss, are the most powerful predictors of survival for women with lung cancer. Patients with prior HRT use do not have inferior outcomes compared to non-HRT users, and the previous published results were not duplicated.

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DOI: http://dx.doi.org/10.3747/co.v16i3.302

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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)