Overall and progression-free survival in endometrial carcinoma: A single-center retrospective study of patients treated between 2000-2018

BACKGROUND: Investigating survival in endometrial cancer (EC) is crucial to determine the effectiveness of overall management as it will reflect on the level of care provided among this population. OBJECTIVE: The study was conducted to analyze the overall survival (OS) and progression-free survival (PFS) in treated endometrial carci-noma and to determine the associated predictors. DESIGN: Retrospective SETTING: Department of obstetrics and gynecology in university ter-tiary hospital PATIENTS AND METHODS: Baseline demographic and clinical data, tumor characteristics and perioperative and outcome data were col-lected from consecutive patients treated for EC between 2000 and 2018. Kaplan-Meier method and multivariate Cox regression were used to analyze factors and predictors of OS and PFS. MAIN OUTCOME MEASURES: OS, PFS and prognostic factors SAMPLE SIZE: 200 RESULT: Endometrioid type was the most common type accounting for 78.5% of the cases, followed by papillary serous carcinoma (18.5%). At diagnosis, 21.5% were stage III, and 12.0% were stage IV. Invasiveness features showed involvement of the myometrium (96.5%), lymph ves-sels (36.5%), cervix stroma (18.5%), lower segment (22.0%), and para-metrium (7.0%). The majority of patients had open surgery (80.0%), while 11.5% and 7.0% had laparoscopy and robotic surgery, respec-tively. Staging and debulking were performed in 89.0% of patients, and 12.5% of patients had residual disease of more than 2 cm. The mean OS and PFS were 104.4 (95% CI=91.8-117.0) months and 96.8 (95% CI=83.9-109.7) months, respectively. The 5-year OS and PFS were 62.5% and 46.9%, respectively. The majority of the factors we assessed were significantly associated with OS or PFS. However, reduced OS was independently associated age >= 60 years (hazard ratio [HR]=1.99, P=.010), papillary serous carcinoma (HR=2.35, P=.021), and residual disease (HR=3.84, P=.007); whereas PFS was predicted by age >= 60 years (HR=1.87, P=.014) and residual disease (HR=3.22, P=.040). CONCLUSION: There is a need for a national strategy to tackle the growing burden of EC, by identifying the locally-specific incidence, de-layed diagnosis and survival outcome. LIMITATIONS: This was a single-center study conducted at a tertiary center, which may question the generalizability of the findings, as the sample may be biased by overrepresentation with patients who were diagnosed at an advanced stage. CONFLICT OF INTEREST: None.

Automated summary

The study investigated the overall survival and progression-free survival in treated endometrial carcinoma and identified associated predictors. The majority of assessed factors were significantly associated with survival rates, and age, cancer type, and residual disease were identified as independent factors affecting survival.