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

Abstract

Abstract 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