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Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Number 10

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Ginecol Obstet Mex 2022; 90 (10)

Analysis of endometrial cancer in a university hospital in Ourense, Spain

Méndez-Míguez I, Couso-Cambeiro B, García-Lavandeira S, Pato-Mosquera M, Santa María-Ortiz J, Bermúdez GM

Language: Spanish
References: 28
Page: 819-825
PDF size: 183.61 Kb.


ABSTRACT

Objective: To retrospectively describe the behavior of endometrial cancer in patients diagnosed at the Complexo Hospitalario Universitario de Ourense.
Materials and Methods: Descriptive, observational and retrospective study in the Complexo Hospitalario Universitario de Ourense between September 2014 and January 2018. Inclusion criteria: diagnosis, treatment and follow-up in our center. Exclusion criteria: incomplete history and diagnosis or management in another center. Patient, tumor and treatment variables were collected. A descriptive analysis was performed. Possible associations were tested by Chi-square, Fisher, Student's t-test and Mann-Whitney test.
Results: 149 patients were studied, with mean age at diagnosis of 69.38 years ± 9.6 years. 86.6% (n = 129) of the patients were postmenopausal. 68% (n = 101) were obese and 54.7% (n = 81) hypertensive. 54.7% (n = 81) were diagnosed at stage IA. 68.4% of grade 3 tumors had myometrial infiltration greater than 50%, 28.6% grade 1 (p ‹ 0.001). Of the patients who received radiotherapy or brachytherapy 46% were advanced stage; 76% stage IB, 26% stage IA (p ‹ 0.001). 91.3% of stage I tumors were type I, in advanced stages there were 48.6% of type I tumors (p ‹ 0.001). 87.4% of grade 1 or 2 tumors were stage I, 45.2% of grade 3 tumors were stage I (p ‹ 0.001).
Conclusions: Most patients were older than 60 years and were diabetic, hypertensive and obese. Endometrial cancer is usually diagnosed at early stages. Brachytherapy is the most indicated adjuvant.


REFERENCES

  1. American Cancer Society. Cancer Facts & Figures 2016.Atlanta: American Cancer Society, 2016. https://doi.org/10.3322/caac.20006

  2. Arnold M, Karim-Kos HE, Coebergh JW, Byrnes G, et al.Recent trends in incidence of five common cancers in 26European countries since 1988: Analysis of the EuropeanCancer Observatory. Eur J Cancer 2015; 51 (9): 1164-87.doi: 10.1016/j.ejca.2013.09.002

  3. Ferlay J, Soerjomataram I, Dikshit R, Eser S, et al. Cancerincidence and mortality worldwide: sources, methods andmajor patterns in GLOBOCAN 2012. Int J Cancer 2015; 136(5): E359-86. doi: 10.1002/ijc.29210

  4. Lee NK, Cheung MK, Shin JY, Husain A, et al. Prognosticfactors for uterine cancer in reproductive-aged women.Obstet Gynecol 2007; 109 (3): 655-62. doi: 10.1097/01.AOG.0000255980.88205.15

  5. Ali AT. Risk factors for endometrial cancer. Ceska Gynekol2013; 78 (5): 448-59.

  6. Colombo N, Preti E, Landoni F, Carinelli S, et al; ESMOGuidelines Working Group. Endometrial cancer: ESMOClinical Practice Guidelines for diagnosis, treatmentand follow-up. Ann Oncol 2013; 24 Suppl 6: vi33-8. doi:10.1093/annonc/mdt353

  7. Santaballa A, Matías-Guiu X, Redondo A, Carballo N, et al.SEOM clinical guidelines for endometrial cancer (2017).Clin Transl Oncol 2018; 20 (1): 29-37. doi: 10.1007/s12094-017-1809-9

  8. Takahashi A, Matsuura M, Matoda M, Nomura H, et al.Clinicopathological features of early and late recurrenceof endometrial carcinoma after surgical resection. IntJ Gynecol Cancer 2017; 27 (5): 967-72. doi: 10.1097/IGC.0000000000000984

  9. Rizzo S, Femia M, Buscarino V, Franchi D, et al. Endometrialcancer: an overview of novelties in treatment and relatedimaging keypoints for local staging. Cancer Imaging 2018;18 (1): 45. doi: 10.1186/s40644-018-0180-6

  10. Hoang LN, Kinloch MA, Leo JM, Grondin K, et al. Interobserver agreement in endometrial carcinoma histotypediagnosis varies depending on the cancer genome atlas(TCGA)-based molecular subgroup. Am J Surg Pathol 2017;41 (2): 245-52. doi: 10.1097/PAS.0000000000000764

  11. Stelloo E, Nout RA, Osse EM, Jürgenliemk-Schulz IJ, et al.Improved risk assessment by integrating molecular andclinicopathological factors in early-stage endometrialcancer-combined analysis of the PORTEC cohorts. ClinCancer Res 2016; 22 (16): 4215-24. doi: 10.1158/1078-0432.CCR-15-2878

  12. Zhang S, Gong TT, Liu FH, Jiang YT, et al. Global, Regional, and National Burden of Endometrial Cancer,1990-2017: Results from the Global Burden of diseasestudy, 2017. Front Oncol 2019; 9: 1440. doi:10.3389/fonc.2019.01440

  13. Friberg E, Mantzoros CS, Wolk A. Diabetes and risk of endometrial cancer: a population-based prospective cohortstudy. Cancer Epidemiol Biomarkers Prev 2007; 16 (2):276-80. doi: 10.1158/1055-9965.EPI-06-0751

  14. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat RevCancer 2004; 4 (8): 579-91. doi: 10.1038/nrc1408

  15. World Cancer Research Fund/American Institute for CancerResearch: Continuous Update Project Expert Report 2018:Diet, nutrition, physical activity, and endometrial cancer.http:// www.dietandcancerreport.org.

  16. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, et al.Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic OncologyGroup Study LAP2. J Clin Oncol 2009; 27 (32): 5331-6. doi:10.1200/JCO.2009.22.3248

  17. Janda M, Gebski V, Davies LC, Forder P, et al. Effect of totallaparoscopic hysterectomy vs total abdominal hysterectomy on disease-free survival among women with stage iendometrial cancer: a randomized clinical trial. JAMA 2017;317 (12): 1224-33. doi: 10.1001/jama.2017.2068

  18. Roh HF, Nam SH, Kim JM. Robot-assisted laparoscopicsurgery versus conventional laparoscopic surgery in randomized controlled trials: A systematic review and metaanalysis. PLoS One 2018; 13 (1): e0191628. doi: 10.1371/journal.pone.0191628

  19. Garg G, Gao F, Wright JD, Hagemann AR, et al. Positiveperitoneal cytology is an independent risk-factor in earlystage endometrial cancer. Gynecol Oncol 2013; 128 (1):77-82. doi: 10.1016/j.ygyno.2012.09.026

  20. Rossi EC, Kowalski LD, Scalici J, Cantrell L, et al. A comparison of sentinel lymph node biopsy to lymphadenectomyfor endometrial cancer staging (FIRES trial): a multicentre,prospective, cohort study. Lancet Oncol 2017; 18 (3): 384-92. doi: 10.1016/S1470-2045(17)30068-2

  21. Ballester M, Dubernard G, Lécuru F, Heitz D, et al. Detectionrate and diagnostic accuracy of sentinel-node biopsy inearly stage endometrial cancer: a prospective multicentrestudy (SENTI-ENDO). Lancet Oncol 2011; 12 (5): 469-76.doi: 10.1016/S1470-2045(11)70070-5

  22. Galaal K, Bryant A, Fisher AD, Al-Khaduri M, Kew F, LopesAD. Laparoscopy versus laparotomy for the managementof early-stage endometrial cancer. Cochrane DatabaseSyst Rev 2012; (9): CD006655. doi: 10.1002/14651858.CD006655.pub2

  23. Keys HM, Roberts JA, Brunetto VL, Zaino RJ, et al; Gynecologic Oncology Group. A phase III trial of surgery withor without adjunctive external pelvic radiation therapy inintermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2004; 92(3): 744-51. doi: 10.1016/j.ygyno.2003.11.048. Erratumin: Gynecol Oncol 2004; 94 (1): 241-2.

  24. Nout RA, Smit VT, Putter H, Jürgenliemk-Schulz IM, etal; PORTEC Study Group. Vaginal brachytherapy versuspelvic external beam radiotherapy for patients withendometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomisedtrial. Lancet 2010; 375 (9717): 816-23. doi: 10.1016/S0140-6736(09)62163-2

  25. Liang LW, Perez AR, Cangemi NA, Zhou Q, et al. Anassessment of prognostic factors, adjuvant treatment,and outcomes of stage ia polyp-limited versus endometrium-limited type II endometrial carcinoma. Int JGynecol Cancer 2016; 26 (3): 497-504. doi: 10.1097/IGC.0000000000000635

  26. Randall ME, Filiaci V, McMeekin DS, von Gruenigen V, etal. Phase III Trial: adjuvant pelvic radiation therapy versus vaginal brachytherapy plus paclitaxel/carboplatin inhigh-intermediate and high-risk early stage endometrialcancer. J Clin Oncol 2019; 37 (21): 1810-18. doi: 10.1200/JCO.18.01575

  27. Bernardini MQ, Gien LT, Lau S, Altman AD, et al. Treatmentrelated outcomes in high-risk endometrial carcinoma: Canadian high risk endometrial cancer consortium (CHREC).Gynecol Oncol 2016; 141 (1): 148-54. doi: 10.1016/j.ygyno.2016.02.002

  28. Patsavas K, Woessner J, Gielda B, Rotmensch J, et al.Optimal surgical debulking in uterine papillary serouscarcinoma affects survival. Gynecol Oncol 2011; 121 (3):581-5. doi: 10.1016/j.ygyno.2010.11.048




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