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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 1

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Study flow diagram.
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Figure 3

Study flow diagram.

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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.

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Summary of findings for the main comparison. Oestrogen replacement therapy compared to placebo for women previously treated for endometrial cancer
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