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01-01-2018 | Clinical Study

Progesterone-only contraception is associated with a shorter progression-free survival in premenopausal women with WHO Grade I meningioma

Authors: Tessa A. Harland, Jacob L. Freeman, Monica Davern, D. Jay McCracken, Emma C. Celano, Kevin Lillehei, Jeffrey J. Olson, D. Ryan Ormond

Published in: Journal of Neuro-Oncology | Issue 2/2018

Abstract

The hormonally active nature of intracranial meningioma has prompted research examining the risk of tumorigenesis in patients using hormonal contraception. Studies exploring estrogen-only and estrogen/progesterone combination contraceptives have failed to demonstrate a consistent increased risk of meningioma. By contrast, the few trials examining progesterone-only contraceptives have shown higher odds ratios for risk of meningioma. With progesterone-only contraception on the rise, the risk of tumor recurrence with these specific medications warrants closer study. We sought to determine whether progesterone-only contraception increases recurrence rate and decreases progression-free survival in pre-menopausal women with surgically resected WHO Grade I meningioma. Comparative analysis of 67 pre-menopausal women taking hormone-based contraceptives (progesterone-only medication, n = 21; estrogen-only or estrogen/progesterone combination medication, n = 46) who underwent surgical resection of WHO Grade I intracranial meningioma was performed. Differences in demographics, degree of resection, adjuvant therapy and time to recurrence were compared between the two groups. Compared to patients taking combination or estrogen-only contraception, those taking progesterone-only contraception demonstrated a greater recurrence rate (33.3 vs. 19.6%) with a reduced time to recurrence (18 vs. 32 months, p = 0.038) despite a significantly shorter follow-up (p = 0.014). There were no significant demographic or treatment related differences. The results from this study suggest that exogenous progesterone-only medications may represent a specific contraceptive subgroup that should be avoided in patients with meningioma.

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Title: Progesterone-only contraception is associated with a shorter progression-free survival in premenopausal women with WHO Grade I meningioma
Authors: Tessa A. Harland
Jacob L. Freeman
Monica Davern
D. Jay McCracken
Emma C. Celano
Kevin Lillehei
Jeffrey J. Olson
D. Ryan Ormond
Publication date: 01-01-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-017-2656-9

At a glance: The STEP trials

Springer Medicine

Progesterone-only contraception is associated with a shorter progression-free survival in premenopausal women with WHO Grade I meningioma

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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