Summary of findings for the main comparison. Oestrogen replacement therapy compared to placebo for women previously treated for endometrial cancer.
| Oestrogen replacement therapy compared to placebo for women previously treated for endometrial cancer | ||||||
| Patient or population: women previously treated for endometrial cancer Setting: oncology follow‐up Intervention: oestrogen replacement therapy Comparison: placebo | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty (quality) of the evidence (GRADE) | Comments | |
| Risk with placebo | Risk with oestrogen replacement therapy | |||||
| Rate of symptom relief | — | — | — | — | — | — |
| Rate of tumour recurrence follow‐up: median 36 months | Study population |
RR 1.17 (0.54 to 2.50) |
1236 (1 RCT) | ⊕⊝⊝⊝ Very low1,2,3 | — | |
| 19 per 1000 | 14 per 1000 (9 to 40) | |||||
| Rate of appearance of a new malignancy follow‐up: median 36 months | Study population | RR 0.80 (0.32 to 2.01) | 1236 (1 RCT) | ⊕⊝⊝⊝ Very low1,2,3 | — | |
| 16 per 1000 | 13 per 1000 (5 to 33) | |||||
| Rate of survival: overall survival | — | — | — | — | — | The single study did not report overall survival of control and intervention groups individually, though it did report the percentage of participants alive at the end of follow‐up (median follow‐up: 35.7 months; 94.3% in the HRT group and 95.6% in the placebo group). |
| Rate of survival: progression‐free survival | — | — | — | — | — | The study did not report progression‐free survival of control and intervention groups individually, though it did report the percentage of participants alive, with no evidence of disease at the end of follow‐up (median follow‐up: 35.7 months; 95.8% in the HRT group and 96.9% in the placebo group). |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect | ||||||
1Downgraded one level as the single RCT was closed prior to achieving its accrual goal. This was a serious departure from the study design and a serious risk of bias.
2Downgraded one level as there were insufficient data with respect to allocation concealment and description of the intervention, along with a significant risk of attrition bias.
3Downgraded one level for imprecision, as the single included study was underpowered to detect significant differences in the primary outcomes.