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450 Endometrial Cancer in Clinical Practice: The Experience of an Oncological Center
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  1. R Fontes,
  2. J Rodrigues,
  3. C Oliveira,
  4. M Peixoto,
  5. F Pereira,
  6. J Cunha,
  7. C Portela,
  8. A Marques,
  9. R Nabiço and
  10. L Queiroz
  1. Portugal, Medical Oncology, Portugal

Abstract

Introduction/Background*Endometrial cancer is the fourth most common malignancy among women and the most frequent gyneacological cancer in developed countries. Generally it is associated with a favourable prognosis mainly because most cases are diagnosed at an early stage. This work aims to evaluate the real-life data of an oncological center.

Methodology Retrospective analysis of data from patients diagnosed and treated in our institution, from January 2009 to December 2019.

Result(s)*During this period, 217 patients were diagnosed with endometrial cancer, with a median age at diagnosis of 67 years. Regarding clinical staging, the majority of them were in early stage disease – FIGO I/II (69%, n=149) and mainly endometrioid histological subtype (71%. n=154).

High-risk endometrial cancer was seen in 41,9% of the patients (n=91). From these, 36,3% (n=33) were treated with adjuvant radiotherapy, with or without braquitherapy, and 56% (n=51) also received chemotherapy (carboplatin + paclitaxel) before radiation treatment. Recorrence occured in 23 patients, mainly FIGO stage IIIC1.

Overall, relapse was detected in 36 patients (16,6%) – 15 patients with loco-regional disease and 21 with distant metastasis – with a median progression free survival of 12 months. Histology was found to be the major risk factor (p=0,05) for recorrence.

To date, the number of deaths was 64 (29,5%), but 15 patients died from other causes. In multivariate analysis, the independent prognostic factos were histology (p=0,01), FIGO stage (p=0,05) and limphovascular involvement (p=0,00), with the last one being the most significant (B=1,077). Overall survival was 82,3% and 72,2% at 2 and 5 years, respectively.

From the 217 patients 61,8% (n=133) are under follow-up, showing no signs of recorrence.

Conclusion*Although endometrial cancer is generaly diagnosed at an early stage, differences in patient characteristics and histopathological features of the disease impact on both prognosis and treatment approach. Over the past few decades, several studies have demonstrated the prognostic importance of different parameters including histological subtype and grade, stage of disease and lymphovascular involvement. Taking into account the advances in the oncology setting, the future will probably be focused on the molecular profile of endometrial cancer.

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