2898 200 Cases of Endometrial Cancer – 10 Year Outcomes

Abstract

Study Objective To investigate the outcomes of 200 women with early stage Endometrial Cancer managed at a District General Hospital over a 10 year period. Design Retrospective audit of 200 patients with confirmed endometrial cancer, within one Trust in Northern Ireland, from 2009-2018. Information was collected from Northern Ireland Electronic Care Record, and subsequently analyzed using Microsoft Excel. Setting Southern Health and Social Care Trust, Northern Ireland Patients or Participants 200 patients were identified from one surgeon's database of recorded cases Interventions N/A Measurements and Main Results 88% were overweight or obese, 74% presented with postmenopausal bleeding, 54% women underwent total laparoscopic hysterectomy (TLH), 28.5% abdominal hysterectomy, 13.5% vaginal hysterectomy (VH), 3.5% Laparoscopic assisted vaginal hysterectomy (LAVH), 0.5% transcervical resection and mirena. Overall complication rate was 5% for both laparoscopic and abdominal hysterectomy groups, 1% for vaginal and LAVH. Breakdown of specific complications available. Conversion rate from laparoscopic to open hysterectomy was 3.6%. Pre-operative histology compared with hysterectomy specimen matched in 78% cases. 3% were significantly upgraded from low to high grade. Pre-operative radiological staging matched the hysterectomy specimen in 69% of cases. 6% were upstaged from Stage 1, to Stage 2 or 3. Overall confirmed recurrence rate was 2.5%. None were detected through standard follow-up pathways. Conclusion This study supports the strong association between high BMI and endometrial cancer. Despite obesity presenting significant surgical challenges, complication rates are low considering the patient demographic. The shortest median length of stay was with vaginal and laparoscopic hysterectomy. Preoperative grading and staging are relatively accurate in our department. Confirmed recurrence rates are low, although a significant proportion of patients are still in follow-up. Clinical follow-up is not useful in detecting recurrence in the majority of patients, which supports a Self Directed Aftercare approach in the majority of early stage endometrial cancers.