{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:32:21Z","timestamp":1782732741501,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The objective of this study is to determine primary survival endpoints in women with recurrent and metastatic endometrial carcinoma (RMEC) treated with progestins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was conducted at The Ottawa Hospital using electronic medical records. Inclusion criteria were a diagnosis of RMEC between 2000 and 2019, endometrioid histology, and \u2265one line of progestin treatment. Progression\u2010free survival (PFS) and overall survival (OS) were estimated using the Kaplan\u2013Meier method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2342 cases reviewed, 74 met inclusion criteria. Sixty\u2010six (88.0%) patients received megestrol acetate and 9 (12.0%) received a progestin alternative. The distribution of tumors by grade was: 1: 25 (33.3%), 2: 30 (40.0%), and 3: 20 (26.7%). The PFS and OS for the entire study sample was 14.3\u2009months (95% CI 6.2\u201317.9) and 23.3\u2009months (14.8\u201336.8), respectively. The PFS for patients with Grade 1\u20132 RMEC was 15.7\u2009months (8.0, 19.5), compared to 5.0\u2009months (3.0, 23.0) with Grade 3 disease. The OS for patients with Grade 1\u20132 versus Grade 3, was 25.9\u2009months (15.3, 40.3) versus 12.5\u2009months (5.7, 35.9), respectively. Thirty\u2010four (45.9%) and 40 (54.1%) patients were treated with 0 and\u2009\u22651 line of chemotherapy. The PFS for chemotherapy\u2010na\u00efve patients was 17.9\u2009months (14.3, 27.0), versus 6.2\u2009months (3.9, 14.8) following \u22651 line of treatment. The OS was 29.1\u2009months (17.9, 61.1) for chemotherapy\u2010na\u00efve patients versus 23.0\u2009months (10.5, 37.6) for patients previously exposed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This real\u2010world data on RMEC suggests there is a role for progestins in select subgroups of women. The PFS for chemotherapy\u2010na\u00efve patients was 17.9\u2009months (14.3, 27.0), versus 6.2\u2009months (3.9, 14.8) following \u22651 line of treatment. The OS was 29.1\u2009months (17.9, 61.1) for chemotherapy\u2010OS was 29.1\u2009months (17.9, 61.1) for chemotherapy\u2010na\u00efve patients versus 23.0\u2009months (10.5, 37.6) for patients previously exposed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.6276","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T11:25:42Z","timestamp":1688729142000},"page":"16173-16180","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Should we abandon hormonal therapy in endometrial cancer? Outcomes of recurrent and metastatic endometrial cancer treated with systemic progestins"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7602-0049","authenticated-orcid":false,"given":"A.","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5151-8198","authenticated-orcid":false,"given":"N. M. Andrews","family":"Wright","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. N.","family":"Forget","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Ramsay","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"School of Epidemiology, Public Health and Preventative Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mallick","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"School of Epidemiology, Public Health and Preventative Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0355-547X","authenticated-orcid":false,"given":"J. I.","family":"Weberpals","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1514010"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1813181"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13246275"},{"key":"e_1_2_10_6_1","unstructured":"Oncology NCPGi.Uterine Neoplasms 2022.www.nccn.org"},{"issue":"8","key":"e_1_2_10_7_1","article-title":"Chemotherapy for advanced, recurrent or metastatic endometrial carcinoma","volume":"2012","author":"Vale CL","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1101\/mcs.a004341"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2018.12.018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0062"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(73)90026-7"},{"issue":"1","key":"e_1_2_10_12_1","first-page":"129","article-title":"Megestrol acetate in the management of advanced endometrial carcinoma","volume":"41","author":"Wait R","year":"1973","journal-title":"Obstet Gynecol"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2017.07.002"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000862"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.8871"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.6.1736"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.2.357"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2003.09.018"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2003.11.008"},{"key":"e_1_2_10_21_1","article-title":"Hormonal therapy in advanced or recurrent endometrial cancer","volume":"12","author":"Kokka F","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01076"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2108330"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.06.037"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232314596"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.6276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T09:34:41Z","timestamp":1715765681000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.6276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,7]]},"references-count":24,"journal-issue":{"issue":"15","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/cam4.6276"],"URL":"https:\/\/doi.org\/10.1002\/cam4.6276","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,7]]},"assertion":[{"value":"2023-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}