Treatments and Outcomes of Endometrial Cancers in Srinagarind Hospital
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Abstract
Objectives: Endometrial cancer was the second most common gynecologic cancer. Despite many standard guidelines, variation of management could still occur. This study was done with the objectives to compare treatments in real-life practice to standard guidelines and oncologic outcomes to quality indicators.
Materials and Methods: This retrospective descriptive analytical study was conducted in 316 endometrial cancer patients registered at Srinagarind Hospital, Khon Kaen University, during 2016-2020. Forty-three patients were excluded and 273 were analyzed. Surgical and adjuvant treatments were compared to standard guidelines. Oncological outcomes were compared to quality indicators. Prognostic factors were also analyzed.
Results: Total hysterectomy with bilateral salpingo-oophorectomies was mostly done in all women (96.3%) and some of them were done via minimal invasive surgery (7.3%). Omentectomies were done in 75.1% and all were negative. Bilateral pelvic node dissection or sampling was done in 51.6%, while 84.9% that should be done in group of those were not. About two-thirds (64.5%) of patients received adjuvant therapies, which 91.5% of their waiting time was within 60 days after surgeries. external beam radiation therapy (EBRT) was done via three-dimensional technique 100%. Over- and under-treatment were found in 16.5% (95% confidence interval (CI) 10.9-22.0) and 19.9% (95%CI 13.9-25.8) of all adjuvant therapies. There was no death within 30 days after surgeries. Three-years overall survival (OS) and recurrence-free survival (RFS) rates were 93.4% and 94.9%, respectively. Significant prognostic factors for both kinds of survivals were stage and residual lesion.
Conclusion: Over- and under-treatment of adjuvant therapy were found in 16.5% and 19.9%, respectively. Oncologic outcomes were good and comparable with others’ despite of low lymphadenectomy rate. However, according to the quality indicators, we had to increase our minimal invasive surgery rate.
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