Evidence-based Medical Analysis On The Safety Of Postoperative Menopausal Hormone Therapy For Endometrial Cancer

Objective:There is little research and a clinically prudent use on the application of menopause hormone therapy for post-operative endometrial cancer.The purpose of this study is to use evidence-based medicine to estimate the safety of MHT on the EC patients after treatments.Methods:We Searched WanFang,CNKI,CBM,VIP,PUBMED,MEDLINE,OVID and other databases.The language is limited to Chinese and English,and the search time is limited from the establishment of the library to January-2019.The literatures that met the inclusion criteria were screened out.After the final screening of the literature was evaluated for quality and the required data were extracted,the study was performed by using ReviewManager5.3 to perform meta-analysis of each group of data.Results:There are 10 studies about mortality and recurrence rates about the MHT after EC therapy.Eight English literatures and two Chinese literatures,one of which was a prospective case-control study,and one was A prospective randomized controlled trial,two for retrospective cohort studies,four for retrospective case-control studies,and two for retrospective matched case-control studies.The literature was evaluated using the Newcastle-Ottawa Scale(NOS)with a score of 5 stars and high quality.The results of the meta-analysis showed that the overall recurrence rate of MHT group and non-MHT group decreased after surgery(RR=0.48,95% CI(0.30-0.77),P=0.002).The results of the meta-analysis showed that the overall mortality rate of MHT group and non-MHT group decreased after surgery(RR=0.44,95%CI(0.21-0.89),P=0.02).Conclusion: MHT after endometrial cancer surgery does not increase the mortality rate of patients,tends to reduce the recurrence rate of endometrial cancer patients,alleviate menopausal symptoms,patients' confidence in life and the quality of life.However,due to the limited quantity and quality of the study,and the existence of selection bias and implementation bias in the research,we need the more large-scale,high-quality studies to conduct more accurate meta-analysis,providing powerful evidence for clinical decision-making.