Description of The Surgical Management of Patients With Uterine Corpus Cancers in Belgium : Results From a Multicentric Prospective Observational Study (Effect).

Background Uterine corpus cancer is the most frequent pelvic gynaecological cancer in Belgium, however the adherence to the management guidelines is widely heterogeneous. In order to assess the quality of management, the EFFECT (EFFectiveness of Endometrial Cancer Treatment) project was initiated by the Anticancer Fund and representatives of Belgian gynaecologists in association with the Belgian Cancer Registry. Here we report the results regarding the surgical management of the patients included in EFFECT.MethodologyPatients with uterine malignant tumours diagnosed between 2012 and 2016 were registered prospectively and on a voluntary basis in an online secured database hosted by the Belgian Cancer Registry (EFFECT study). Data on pathologic assessment, preoperative management, surgery, adjuvant treatment and follow-up were collected. We present the demographic characteristics, pathological assessment and surgical management of the whole study population.ResultsOverall, 4,037 new cases were registered by 59 participating centres. The mean number of patients treated by each center was 65, 14 centres registered more than 100 patients during the whole period. The median patients’ age was 69 years (range, 22-98 years). 95.5% of operated malignant tumours were carcinomas, 4.5% were sarcomas. 78% of the patients with a carcinoma and 75% of the sarcomas were FIGO stage I. 56% of operated patients were treated by minimally invasive surgery (laparoscopy or robot-assisted laparoscopy), 36% by laparotomy and 7% by exclusive vaginal surgery. 44% of the operated patients had surgical lymph node staging (72% pelvic lymphadenectomy, 2% para-aortic lymphadenectomy, 22% pelvic and para-aortic lymphadenectomy). The median number of pelvic nodes resected was 17 (0-73) and for para-aortic nodes 11 (0-84).ConclusionDespite FIGO stage I tumours accounted for 78% of patients, only 56% of them profited from a minimally invasive surgical approach. Further analysis will assess the Quality of Care and hopefully permit to improve surgical and oncologic outcomes by the feedback provided to the different centres.