Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Uterine Cancer: A Nine-year Review from a Tertiary Hospital in Tamil Nadu

Author(s): Krishnapriya Leela, Chippy Tess Mathew* and Umamaheswari Gurusamy

Volume 20, Issue 5, 2024

Published on: 13 September, 2023

Article ID: e310723219307 Pages: 9

DOI: 10.2174/1573404820666230731153002

Price: $65

conference banner
Abstract

Background: With increasing uterine cancer in developing nations, there is a need for timely determination of the diagnosis, prognosis, and management options to reduce morbidity and mortality.

Objective: To analyze the socio-demographic, etio-pathological features and management of uterine cancer and evaluate its correlation with grading/staging in our population.

Methods: This retrospective descriptive study analyzed data from 97 histologically proven uterine cancer cases. Age, parity, symptoms, co-morbidities, body mass index (BMI), ultrasound features, histopathology type, stage and grade of the tumor, type of hysterectomy done, complications and mortality were analysed. Statistical analysis was done using ANOVA and chi-square test, and a p-value<0.05 indicated statistical significance.

Results: The mean age of diagnosis was 57.91 years, and the mean BMI was 29.32 Kg/m2. Majority of the patients were multiparous (42.27%), and only 10% were nulliparous. The disease was detected at an earlier age in nulliparous and obese women. Diabetes and hypertension were found in 75.25%. Most of the patients were detected with stage I cancer (80.6%). Patients diagnosed with uterine cancer on biopsy were treated with total abdominal hysterectomy with bilateral salpingo-oophorectomy andbilateral pelvic lymph node dissection (55.8%). Over 36% of patients received postop radiotherapy and/or chemotherapy. 21% patients were lost to follow-up and 12.37% died. Also, 24 cases had postoperative complications (wound infection).

Conclusion: Uterine cancer is common among obese women with diabetes and hypertension. In nulliparous and the obese, the cancer was detected at an earlier age. Most of our patients had stage 1 disease, and 90% was endometroid cancer. The study highlights the importance of endometrial sampling before hysterectomy in perimenopausal women to avoid suboptimal surgery in patients diagnosed with uterine cancer after a simple hysterectomy.

Keywords: Uterine cancer, demographic factors, grading, staging, obese, parity.

Graphical Abstract
[1]
Zhang, S.; Gong, T.T.; Liu, F.H. Global, regional, and national burden of uterine cancer, 1990-2017: Results from the Global Burden of Disease study, 2017. Front. Oncol., 2019, 9, 1440.
[http://dx.doi.org/10.3389/fonc.2019.01440] [PMID: 31921687]
[2]
Sravanthi, B.; Latha, K.V.S. A study of correlation of clinical variables with presenting stage and type of uterine cancer at a tertiary care hospital: A retrospective study. Int. J. Sci. Stud., 2019, 7(6), 92-97.
[3]
Abu-Zaid, A.; Al-Badawi, I.A. Past, present and future perspectives on the management of uterine cancer– a comprehensive review; Contemporary Gynecologic Practice. 1st ed., 2015. https://www.intechopen.com/chapters/47444
[4]
Tinelli, A.; Vergara, D.; Martignago, R.; Leo, G.; Malvasi, A.; Tinelli, R. Hormonal carcinogenesis and socio-biological development factors in endometrial cancer: A clinical review. Acta Obstet. Gynecol. Scand., 2008, 87(11), 1101-1113.
[http://dx.doi.org/10.1080/00016340802160079] [PMID: 18607816]
[5]
Kehoe, S. Uterine cancer. Dewhurst’s Textbook of Obstetrics and Gynaecology. John Wiley and Sons, 2012, Vol. 10, 776.
[http://dx.doi.org/10.1002/9781119979449.ch58]
[6]
Enrique Hernandez, J.S.F. Uterine carcinoma.Clinical Gynecology, 2nd ed; Cambridge University Press, 2015, pp. 755-768.
[7]
Murali, R.; Soslow, R.A.; Weigelt, B. Classification of endometrial carcinoma: More than two types. Lancet Oncol., 2014, 15(7), e268-e278.
[http://dx.doi.org/10.1016/S1470-2045(13)70591-6] [PMID: 24872110]
[8]
Lewin, S.N.; Herzog, T.J. Comparative performance of the 2009 international Federation of gynecology and obstetrics’ staging system for uterine corpus cancer. Obstet. Gynecol., 2010, 116(5), 1141-1149.
[9]
Siegel, R.; Naishadham, D.; Jemal, A. Cancer statistics, 2013. CA Cancer J. Clin., 2013, 63(1), 11-30.
[http://dx.doi.org/10.3322/caac.21166] [PMID: 23335087]
[10]
Braun, M.M.; Overbeek-Wager, E.A.; Grumbo, R.J. Diagnosis and management of uterine cancer. Am. Fam. Physician, 2016, 93(6), 468-474.
[PMID: 26977831]
[11]
Garg, K.; Soslow, R.A. Endometrial carcinoma in women aged 40 years and younger. Arch. Pathol. Lab. Med., 2014, 138(3), 335-342.
[http://dx.doi.org/10.5858/arpa.2012-0654-RA] [PMID: 24576029]
[12]
Jia, X.; Yang, L.; Xu, P.; Li, N.; Chen, C.; Wang, H. Endometrial cancer combined with polycystic ovary syndrome in 9 women under 40 years old: A case report. Biomed. Rep., 2020, 13(5), 1.
[http://dx.doi.org/10.3892/br.2020.1357] [PMID: 32963779]
[13]
Shaw, E.; Farris, M.; McNeil, J.; Friedenreich, C. Cancer Res., 2016, 208, 107-136.
[14]
Gao, Y.; Dai, X.; Chen, L. Body mass index is positively associated with endometrial cancer in chinese women, especially prior to menopause. J. Cancer, 2016, 7(9), 1169-1173.
[http://dx.doi.org/10.7150/jca.15037] [PMID: 27326261]
[15]
Schmandt, R.E.; Iglesias, D.A.; Co, N.N.; Lu, K.H. Understanding obesity and endometrial cancer risk: Opportunities for prevention. Am. J. Obstet. Gynecol., 2011, 205(6), 518-525.
[http://dx.doi.org/10.1016/j.ajog.2011.05.042] [PMID: 21802066]
[16]
Renehan, A.G.; Tyson, M.; Egger, M.; Heller, R.F.; Zwahlen, M. Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies. Lancet, 2008, 371(9612), 569-578.
[http://dx.doi.org/10.1016/S0140-6736(08)60269-X] [PMID: 18280327]
[17]
Chen, Q.; Tong, M.; Fang, G.; Lau, S.Y.; Zhao, M. Parity correlates with timing of development of uterine cancer, but not the subtype of uterine cancer. J. Cancer, 2015, 6(11), 1087-1092.
[http://dx.doi.org/10.7150/jca.12736] [PMID: 26516355]
[18]
Gullo, G.; Cucinella, G.; Chiantera, V. Fertility-sparing strategies for early-stage endometrial cancer: Stepping towards precision medicine based on the molecular fingerprint. Int. J. Mol. Sci., 2023, 24(1), 811.
[http://dx.doi.org/10.3390/ijms24010811] [PMID: 36614253]
[19]
Tanos, P.; Dimitriou, S.; Gullo, G.; Tanos, V. Biomolecular and genetic prognostic factors that can facilitate fertility-sparing treatment (FST) decision making in early stage endometrial cancer (ES-EC): A systematic review. Int. J. Mol. Sci., 2022, 23(5), 2653.
[http://dx.doi.org/10.3390/ijms23052653] [PMID: 35269800]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy