Analysis of endometrial cancer cases seen in a tertiary referral hospital

Analysis of endometrial cancer cases seen in a tertiary referral hospitalK. Gu00fczin. A. u00d6zer, A. Tok, u015e.AydogduSu00fctu00e7u00fc Imam University, Kahramanmarau015f, TurkeyIntroduction: Endometrial cancer is the most common gynecologic cancer in women. It is mostly diagnosed at early stages. It was aimed to present demographic and clinical characteristics of 33 cases diagnosed as endometrium cancer in a tertiary referral hospital.Methods: Medical records of 33 patients who had been diagnosed histopathologically as endometrium cancer between June 2017 and March 2019 were analysed retrospectively. Data regarding demographic and clinical characteristics were recorded. FIGO 2009 staging system was used to determine stage of the endometrioial carcinomas. Grade 1 and 2 endometrioid adenocarcinomas were classified as type 1 endometrial carcinomas. Grade 3 endometrioid adenocarcinomas and the endometrial cancers with non-endometrioid histologie were classified as type 2 endometrial carcinomas [1]. One patient diagnosed as undifferentiated endometrial stromal sarcoma had not been included in either Type 1 or 2. Results: Demographic characteristics were displayed on Table 1. The majority of the cases (90,6%) was postmenopausal and were diagnosed as endometrioid adenocancer (81.3%).90.6 % of the cases were multiparous and 68.8 % of the cases were obese (BMI≥30kg/m2). Pelvic and paraaortic lymph node dissection was performed in 88.5% of the endometrioid adenocancers and 75% of the serous papillary cancers (Table 2).There was no statistically significant difference between type 1and 2 endometrial cancers regarding the mean age (60.2±6.9 vs 51.8±20.1 years in Type 1 and 2 retrospectively), the rate of obesity, menopausal status and the confinement to the uterus (p<0.05 for all) (Table 3).Conclusion: Endometrial cancer is the most common gynecologic cancer in women. It is mostly diagnosed at early stages. Among adenocarcinomas, type 1 endometrial carcinomas, which consists of endometrioid histology and lower grade, account for 70-80% of the cases and are usually diagnosed at early stages. Type 2 endometrial carcinomas which develop from atrophic endometrium are diagnosed generally in older women and at later stages [2]. However, in the present study the mean age was similar in both groups of type 1 and 2 endometrial carcinomas.In the current study, though statistically insignificant, the number of of the cases confined to the uterus (15/21, 71.4%) in type 1 endometrial carcinomas were higher compared to the type 2 endometrial carcinomas.Table 1: Demographic and clinical characteristics of the cases Age (years)*t61.0 (38,0-74,0)Gravida*t4.0 (0-12,0)Parity*t3.0 (0-10,0)Body mass index (Kg/m2)u2020t34.3±1.25Hystologic subtypeu00a5Endometrioid adenocancerClear cellSerous papillar cancerUndifferentiated endometrial stromal sarcomat27 (81,3%)1(3,1%)4 (12,5%)1 (3,1%)Menopause statusu00a5 Premenopause Postmenopause t4 (9.4%)29(90.6%)PPLNDu00a5YesNot20(60.1%)13(39.9%)*Values were expressed as median (minumum-maximum), u2020It was expressed as mean±standart deviation, u00a5Values were expressed as numbers (percentages), PPLND: Pelvic paraaortic lymph node dissectionTable 2: Clinical characteristics of the cases according to the histologic typesHistologic typetEndometrioid adenocancer (n=26)tClear cell carcinoma(n=1)tSerous papillary cancer(n=4)tUndifferentiated endometrial stromal sarcoma(n=1)Menopause status* Premenopause Postmenopause t3(11.5%)23(88.5%)t1(100%)t4 (100%)t1(100%)PPLND*YesNot151(57.7%)111(42.3%)t1(100%)t3(75.0%)1(25.0%)t1(100%)Stage*1A1B23A3C13C24A4Bt16(61.5%)3(11.5%)1(3.9%)3(11.5%)2 (7.7%)1(3.9%)00t000001(100%)00t1(25.0%)00002 (50%) 1(25.0%)0t00000001(100%)*Values were expressed as numbers (percentages), PPLND: Pelvic paraaortic lymph node dissectionTable 3: Comparison of Type 1 and 2 endometrium adenocarcinomatType 1 endometrium adenocarcinoma (n=21)tType 2 endometrium adenocarcinoma (n=10)tP valueAge (years)*t62(41-69)t58(41-74)t0.340Menopause statusu00a5 PremenopausePostmenopauset1(4.8%)20(95.2%)t2(20%)8(80%)t0.237PPLNDu00a5YesNot13(61.9%)8(38.1%)t6(60%)4 (40%)t0.919Body mass index (Kg/m2)t33.7 ±6.4t35.4± 9.5tObeseu00a5YesNot15(71.4%)6(28.8%)t6(60%)4(40%)t0.544Disease confined to uterusu00a5YesNot15(71.4%)6(28.8%)t5(50%)5(50%)t0.244*Values were expressed as median (minumum-maximum),u00a5Values were expressed as numbers (percentages), PPLND: Pelvic paraaortic lymph node dissectionReferences: 1. Amant, F. , Mirza, M. R., Koskas, M. and Creutzberg, C. L. Cancer of the corpus uteri. Int J Gynecol Obstet, 2018;143: 37-50. 2. Setiawan VW, Yang HP, Pike MC, et al. Type I and II endometrial cancers: have they different risk factors?. J Clin Oncol. 2013;31(20):2607–2618. doi:10.1200/JCO.2012.48.2596