Retrospective Clinico-epidemiological Study of Endometrial Carcinoma, Mansoura Experience

Abstract

Aims: Determining epidemiological characteristics and treatment outcome of endometrial carcinoma (EC) patients treated at Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt from Jan 2000 to Dec 2013 inclusive. Study Design: Retrospective study. Place and Duration of Study: Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt. Methodology: Clinical data of 226 EC patients were retrospectively abstracted from the records. Data collected included presenting symptoms, detailed examination and investigations, the treatment protocol, and the outcome. Results: Post-menopausal females were 183 (81%). The incidence of disease was 75.7% among cases with BMI 30-39.9. Forty-two (18.6%) were diagnosed with positive family history. Postmenopausal bleeding was the most common presenting symptom (79.6%). Endometrioid adenocarcinoma was the most common pathology (85.4%) and 48 (21.2%) were diagnosed as grade III.Eighty-four (37.2%) were stage IB and 62 (27.4%) were stage 1A.EC was classified into Low-risk cases (FIGO 2009 stage IA, grade 1 or 2, of endometrioid type histology, intermediate-risk cases ( stage IA grade 3 endometrioid EC&IB grade 1,2 ) and high-risk cases( FIGO stage IB of grade 3 or non-endometrioid histology, stage II, and any stage with non-endometrioid histology). Most of our patients were intermediate risk [95 patients (42.1%)] followed by high risk [81 patients (35.8%)]. Adjuvant treatment was received by 183 patients (90% of whom were intermediate and high risk). Combined EBRT plus brachytherapy was not given to low-risk patients. The 5- year DFS & OS were 46.4% & 65.1% respectively.BMI, ECOG, tumour grade, staging, using EBRT plus VBT and using combined chemotherapy and radiotherapy were the significant prognostic factors. Conclusion: The majority of our EC cases were obese post-menopausal women having early stages and intermediate-risk disease. Serious investigation of postmenopausal bleeding is a must and tailoring the therapy of EC based on the risk category is worthy.