Endometrial cancer survival after breast cancer in relation to tamoxifen treatment: Pooled results from three countries

Jones, Michael E; van Leeuwen, Flora E; Hoogendoorn, Wilhelmina E; Mourits, Marian JE; Hollema, Harry; van Boven, Hester; Press, Michael F; Bernstein, Leslie; Swerdlow, Anthony J

doi:10.1186/bcr3206

Table 5 Endometrial cancer mortality and tamoxifen use, by morphology

From: Endometrial cancer survival after breast cancer in relation to tamoxifen treatment: Pooled results from three countries

	All morphological types				Morphology^a
					Endometrioid				Non-endometrioid^b
	d	n	HR^c	95% CI	d	n	HR^d	95% CI	d	n	HR^d	95% CI
Tamoxifen use
Not used	86	737	1.00	baseline	57	651	1.00	baseline	27	80	1.00	baseline
Used	191	1138	1.17	0.89, 1.55	105	929	1.01	0.72, 1.43	79	190	1.19	0.74, 1.89
	P-het (1 d.f.) = 0.26				P-interaction (1 d.f.) = 0.57
Duration of tamoxifen use
Not used	86	737	1.00	baseline	57	651	1.00	baseline	27	80	1.00	baseline
Used, < 2 years	29	313	0.71	0.46, 1.09	20	272	0.77	0.46, 1.29	8	40	0.50	0.23, 1.12
2 - < 5 years	61	397	1.18	0.84, 1.67	27	326	0.82	0.51, 1.32	30	62	1.64	0.94, 2.86
5 or more years	86	365	1.59	1.13, 2.25	49	285	1.43	0.94, 2.19	35	73	1.56	0.91, 2.69
Used, duration unknown	15	63	2.45	1.38, 4.36	9	46	3.14	1.50, 6.57	6	15	1.29	0.51, 3.26
	P-het (4 d.f.) = 0.0002				P-trend interaction (1 d.f.) = 0.36
	P-trend (1 d.f.) = 0.0055				P-trend (1 d.f.) = 0.0023				P-trend (1 d.f.) = 0.22
Cumulative tamoxifen dose (mg)^e
Not used	86	737	1.00	baseline	57	651	1.00	baseline	27	80	1.00	baseline
Used, < 7500	16	132	0.90	0.52, 1.55	12	114	1.06	0.57, 2.00	4	18	0.57	0.20, 1.65
7500 to < 15,000	15	159	0.72	0.41, 1.26	9	138	0.63	0.31, 1.29	5	20	0.83	0.31, 2.18
15,000 to < 30,000	32	239	1.06	0.70, 1.61	15	199	0.84	0.47, 1.51	15	35	1.38	0.72, 2.64
30,000 to < 60,000	56	294	1.40	0.97, 2.02	23	230	0.91	0.55, 1.51	31	59	1.64	0.94, 2.87
≥ 60,000	52	230	1.40	0.95, 2.05	32	185	1.29	0.81, 2.07	18	41	1.26	0.68, 2.36
Used, amount unknown	20	84	2.13	1.26, 3.58	14	63	2.86	1.54, 5.33	6	17	1.11	0.44, 2.81
	P-het (6 d.f.) = 0.022				P-trend interaction (1 d.f.) = 0.89
	P-trend (1 d.f.) = 0.10				P-trend (1 d.f.) = 0.38				P-trend (1 d.f.) = 0.36
Daily tamoxifen dose (mg/day)
Not used	86	737	1.00	baseline	57	651	1.00	baseline	27	80	1.00	baseline
< 25 mg/day^f	115	738	1.10	0.81, 1.50	63	610	0.97	0.66, 1.43	49	119	1.32	0.79, 2.20
≥ 25 mg/day^g	62	343	1.25	0.88, 1.76	31	277	0.94	0.59, 1.48	27	59	1.11	0.64, 1.93
Used, dose unknown	14	57	1.74	0.96, 3.15	11	42	2.65	1.35, 5.20	3	12	0.72	0.21, 2.50
	P-het (3 d.f.) = 0.28				P-trend interaction (1 d.f.) = 0.90
	P-trend (1 d.f.) = 0.86				P-trend (1 d.f.) = 0.68				P-trend (1 d.f.) = 0.60
Time since last use (based on date of diagnosis of endometrial cancer)
Not used	86	737	1.00	baseline	57	651	1.00	baseline	27	80	1.00	baseline
Still on/≤ 3 months	107	764	0.92	0.68, 1.26	62	649	0.82	0.56, 1.21	42	108	1.11	0.66, 1.88
3 months to < 1 year	14	87	1.12	0.63, 1.99	9	70	1.27	0.62, 2.62	4	13	0.64	0.22, 1.85
1 year to < 3 years	20	100	1.62	0.99, 2.67	7	73	0.90	0.41, 1.98	12	24	1.64	0.82, 3.30
3 years to < 5 years	13	53	1.91	1.05, 3.46	5	35	1.39	0.55, 3.50	6	15	1.82	0.73, 4.55
5 or more years	22	72	2.22	1.36, 3.61	13	56	2.11	1.13, 3.94	9	16	1.52	0.68, 3.38
Used, time unknown	15	62	2.11	1.19, 3.72	9	46	3.08	1.49, 6.38	6	14	1.23	0.49, 3.11
	P-het (6 d.f.) = 0.0007				P-trend interaction (1 d.f.) = 0.52
	P-trend (1 d.f.) = 0.012				P-trend (1 d.f.) = 0.0033				P-trend (1 d.f.) = 0.20
Interval between tumors
3 - 11 months	9	116	0.83	0.40, 1.69	8	102	1.08	0.49, 2.38	1	13	0.19	0.02, 1.43
1 - 2 years	44	453	1.00	baseline	29	400	1.00	baseline	14	48	1.00	baseline
3 - 4 years	47	357	1.33	0.88, 2.01	22	305	1.02	0.59, 1.79	22	48	1.16	0.58, 2.33
5 - 9 years	110	635	1.62	1.13, 2.32	56	508	1.41	0.89, 2.23	52	117	1.31	0.71, 2.42
10 - 29 years	67	314	2.06	1.38, 3.08	47	265	2.18	1.35, 3.53	17	44	1.01	0.47, 2.16
	P-het (4 d.f.) = 0.0017				P-interaction (1 d.f.) = 0.13
	P-trend (1 d.f.) = 0.0048				P-trend (1 d.f.) = 0.0003				P-trend (1 d.f.) = 0.49

^aExcludes those (9 endometrial deaths among 25 patients) where morphology was missing; ^bSerous and clear cell, carcinosarcoma, sarcoma, excludes those where morphology unknown; ^cAdjusted for time since diagnosis of endometrial cancer, study, calendar period, and attained age; ^dAdjusted for time since diagnosis of endometrial cancer, study, calendar period, attained age, and FIGO stage; ^eTrend evaluated on log10 transformed cumulative dose;
^fMostly 20 mg/day; ^gMostly 40 mg/day. CI, confidence interval; d, number of deaths attributed to endometrial cancer; HR, hazard ratio; n, number of patients.

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