Objective: To assess the efficacy of adjuvant progestagen therapy for the treatment of endometrial cancer.
Design: Computerised literature review by MEDLINE backed up by a manual search of 16 journals published before January 1995, to identify relevant published randomised controlled trials. Trials were classified according to methodological quality criteria. Odds ratios and 95% confidence intervals (CIs) were calculated where data allowed.
Setting: Institute of Epidemiology and Health Service Research, University of Leeds.
Subjects: Patients presenting with endometrial cancer.
Intervention: Adjuvant progestagen therapy.
Outcomes: Death (overall, cancer related and intercurrent) and relapse.
Results: Six randomised controlled trials comparing adjuvant progestagen with no adjuvant therapy in the treatment of endometrial cancer were identified in the literature prior to January, 1995. Three trials had an acceptable method of randomisation. Meta-analysis demonstrated that overall survival was not improved by adjuvant progestagen therapy and may even have been adversely affected. Furthermore, this treatment was not associated with any reduction in relapse or death from endometrial cancer.
Conclusion: Current evidence does not support use of adjuvant progestagen therapy in the primary treatment of endometrial cancer.