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CC BY-NC-ND 4.0 · South Asian J Cancer 2023; 12(01): 087-092
DOI: 10.1055/s-0042-1757550
Original Article
Uterine Cancer

Clinical Outcomes of Uterine Body Cancers Treated in a Tertiary Cancer Center

K. Muthulingeshkumar
1   Department of Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Jagadesan Pandjatcharam 
1   Department of Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Latha Chaturvedula
2   Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Abstract

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K. Muthulingeshkumar

Objectives This article reports the clinical outcomes of uterine body cancers in South Indian population. The primary outcome of our study was overall survival (OS). The secondary outcomes were disease-free survival (DFS), patterns of recurrence, toxicities of radiation treatment, and the association of patient, disease, and treatment characteristics with survival and recurrence.

Materials and Methods Records of the patients diagnosed as malignancy in uterus and treated with surgery alone or with adjuvant treatment from January 2013 to December 2017 were retrieved after Institute Ethics Committee approval. Demographic, surgical, histopathology, and adjuvant treatment details were retrieved. Patients of endometrial adenocarcinoma were stratified according to the European Society of Medical Oncology/European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology consensus for analysis and overall outcomes irrespective of histology were also analyzed.

Statistical Analysis For the survival analysis, Kaplan–Meier survival estimator was used. Cox regression was used to test the significance of association of factors with outcomes in terms of hazard ratio (HR).

Results A total of 178 patient records were retrieved. The median follow-up of all patients was 30 months (0.5–81 months). The median age of the population was 55 years. Most common histology was endometrioid type of adenocarcinoma (89%), sarcomas comprised only 4%. The mean OS of all patients was 68 months (n = 178), median was not reached. Five-year OS was 79 %. Five-year OS rates observed in low, intermediate, high-intermediate, and high-risk were 91, 88, 75, and 81.5%, respectively. The mean DFS was 65 months, median not reached. The 5-year DFS was 76%. The 5-year DFS rates observed were 82, 95, 80, and 81.5% for low, intermediate, high-intermediate, and high-risk, respectively. Univariate analysis using Cox regression showed increase in hazard for death in case of node positivity, HR 3.96 (p 0.033). The HR for disease recurrence was 0.35 (p = 0.042) in patients who had received adjuvant radiation therapy. No other factors had any significant impact on death or disease recurrence.

Conclusion The survival outcomes in terms of DFS and OS were comparable with other Indian and Western data reported in the published literature.

Keywords

endometrial cancer - ESMO-ESGO- ESTRO consensus risk - FIGO staging - recurrence pattern - survival pattern

Institutional Ethics Committee Approval

Project ID: JIP/IEC/2018/387

Date of Approval: 18/12/2018




Publication History

Article published online:
02 November 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Colombo N, Creutzberg C, Amant F. et al; ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2016; 27 (01) 16-41
    CrossrefPubMedGoogle Scholar
  • 2 Sung H, Ferlay J, Siegel RL. et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71 (03) 209-249
    Google Scholar
  • 3 Creasman WT, Odicino F, Maisonneuve P. et al. Carcinoma of the corpus uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006; 95 (Suppl 1): S105-S143
    PubMedGoogle Scholar
  • 4 Jemal A, Siegel R, Ward E. et al. Cancer statistics, 2006. CA Cancer J Clin 2006; 56 (02) 106-130
    CrossrefPubMedGoogle Scholar
  • 5 Goff BA, Kato D, Schmidt RA. et al. Uterine papillary serous carcinoma: patterns of metastatic spread. Gynecol Oncol 1994; 54 (03) 264-268
    CrossrefPubMedGoogle Scholar
  • 6 Salazar OM, Bonfiglio TA, Patten SF. et al. Uterine sarcomas: natural history, treatment and prognosis. Cancer 1978; 42 (03) 1152-1160
    CrossrefPubMedGoogle Scholar
  • 7 Mahantshetty U, Aggarwal A, Ganesh B. et al. Clinical outcome of early-stage endometroid adenocarcinoma: a tertiary cancer center experience. Int J Gynecol Cancer 2013; 23 (08) 1446-1452
    CrossrefPubMedGoogle Scholar
  • 8 Kumar UP, Yathiraj PH, Sharan KT. et al. Patterns of recurrence, long-term survival and toxicity analysis of endometrial adenocarcinoma patients reclassified under the recent ESMO-ESGO-ESTRO stratification: seven-year results from a single institution. Int J Gynecol Cancer 2018; 28 (05) 854-860
    CrossrefPubMedGoogle Scholar
  • 9 Nout RA, Smit VT, Putter H. et al; PORTEC Study Group. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet 2010; 375 (9717): 816-823
    CrossrefPubMedGoogle Scholar
  • 10 Creutzberg CL, Nout RA, Lybeert ML. et al; PORTEC Study Group. Fifteen-year radiotherapy outcomes of the randomized PORTEC-1 trial for endometrial carcinoma. Int J Radiat Oncol Biol Phys 2011; 81 (04) e631-e638
    CrossrefPubMedGoogle Scholar
  • 11 Nout RA, van de Poll-Franse LV, Lybeert ML. et al. Long-term outcome and quality of life of patients with endometrial carcinoma treated with or without pelvic radiotherapy in the post operative radiation therapy in endometrial carcinoma 1 (PORTEC-1) trial. J Clin Oncol 2011; 29 (13) 1692-1700
    CrossrefPubMedGoogle Scholar