Timing of surgery and the ovarian cycle

in Endocrine-Related Cancer
Author: R Sainsbury
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The results of Badwe et al. (1991) which showed a significantly better outcome for premenopausal patients operated on during the luteal phase of the menstrual cycle as opposed to the follicular phase (days 2-12) have attracted much interest. The hypothesis invoked was of increased likelihood of metastasis if surgery was carried out during the period of unopposed oestrogen secretion. The effect demonstrated was so great that merely by changing the operative time an effect greater than that achievable by adjuvant chemotherapy was conferred.A number of retrospective series failed to confirm this relationship and some found an opposite effect (Sainsbury et al. 1991, Stonelake et al. 1995). More recently, Levine et al. (1997) reported a series of patients treated in the context of a chemotherapy trial in which menstrual data were recorded. They found a significant effect for node-positive patients who survived better when surgery was performed in the follicular

 

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