在卵巢癌诊断前使用更年期激素疗法（MHT）与提高生存率相关，但这种关联是否因类型和使用持续时间而异尚无定论；关于治疗后使用 MHT 的数据，特别是对健康相关生活质量 (HRQOL) 的影响的数据很少。我们在澳大利亚前瞻性全国队列中根据诊断前后 MHT 使用情况以及治疗后 MHT 使用情况及其与 HRQOL 的关系，调查了卵巢癌女性的生存情况。我们使用 Cox 比例风险回归来估计风险比 (HR) 和 95% 置信区间 (CI) 以及倾向评分，以减少适应症的混杂因素。在 690 名诊断时处于围绝经期/绝经后的女性中，诊断前使用 MHT 与卵巢癌特异性生存率显着提高 26% 相关；与高级别浆液性癌的相关性稍强（HGSC，HR = 0.69，95%CI 0.54-0.87）。这些关联并没有因最近使用时间或使用持续时间而有所不同。在绝经前/围绝经期或诊断时年龄≤55岁的HGSC女性中（n = 259），治疗后使用MHT与生存率差异无关（HR = 1.04，95%CI 0.48-2.22）。与非使用者相比，治疗后开始 MHT 的女性在开始 MHT 之前报告总体 HRQOL 较差，并且这种差异在开始 MHT 后 1-3 个月仍然可见。总之，诊断前 MHT 的使用与生存率的提高相关，特别是在 HGSC 中。在 ≤55 岁的女性中，治疗后使用 MHT 与 HGSC 生存率较差无关。需要进一步的大规模研究来了解卵巢癌中更年期特异性的 HRQOL 问题。© 2024 作者。约翰·威利出版的《国际癌症杂志》

Menopausal hormone therapy (MHT) use before ovarian cancer diagnosis has been associated with improved survival but whether the association varies by type and duration of use is inconclusive; data on MHT use after treatment, particularly the effect on health-related quality of life (HRQOL), are scarce. We investigated survival in women with ovarian cancer according to MHT use before and after diagnosis, and post-treatment MHT use and its association with HRQOL in a prospective nationwide cohort in Australia. We used Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) and propensity scores to reduce confounding by indication. Among 690 women who were peri-/postmenopausal at diagnosis, pre-diagnosis MHT use was associated with a significant 26% improvement in ovarian cancer-specific survival; with a slightly stronger association for high-grade serous carcinoma (HGSC, HR = 0.69, 95%CI 0.54-0.87). The associations did not differ by recency or duration of use. Among women with HGSC who were pre-/perimenopausal or aged ≤55 years at diagnosis (n = 259), MHT use after treatment was not associated with a difference in survival (HR = 1.04, 95%CI 0.48-2.22). Compared to non-users, women who started MHT after treatment reported poorer overall HRQOL before starting MHT and this difference was still seen 1-3 months after starting MHT. In conclusion, pre-diagnosis MHT use was associated with improved survival, particularly in HGSC. Among women ≤55 years, use of MHT following treatment was not associated with poorer survival for HGSC. Further large-scale studies are needed to understand menopause-specific HRQOL issues in ovarian cancer.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.