514 Endometrial cancer in pre-menopausal women: clinical and prognostic factors analysis in a tertiary centre

Abstract

<h3>Introduction/Background*</h3> Management of endometrial cancer (EC) in pre-menopausal women represents nowadays a clinical challenge. The median age of diagnosis of EC is 65 years. Prevalence has increased in the last years in younger people related to increased risk factors. Around 20% of cases are diagnosed before menopause. EC typically presents with abnormal uterine bleeding. The diagnostic evaluation of pre-menopausal patients with this main clinical feature supposes an additional difficulty. The aim of our study is to evaluate the clinical and pathologic factors associated with EC in this group. <h3>Methodology</h3> Retrospective unicentric study of 244 patients with EC diagnosed, treated and followed-up at <i>Hospital Universitario 12 de Octubre</i> (Madrid, Spain) between 2013 and 2020. Exclusion criteria were neoadjuvant chemotherapy or primary radiation as treatment. Menopausal status at diagnosis was used to classify patients into two groups. <h3>Result(s)*</h3> A total of 244 patients were included, of which 45 (18.4%) were pre-menopausal and 199 (81.6%) were postmenopausal. <b>Demographic and pathologic characteristics of the two cohorts are described in table 1.</b> <h3>Conclusion*</h3> In our institution, premenopausal status was associated with a lower parity record (1.1±0.8 vs 2.15±1.3, p=0.04), lower prevalence of hypertension (13.0% vs 59.4%, p=0.001), higher rate of smokers (28.9% vs 14.9%, p=0.039) and endometrioid histology (97.8% vs 83.5%, p=0.01). Hysterectomy was performed in all cases, and only one premenopausal patient underwent ovarian preservation. A total of 39.1% and 38.0% of the patients had pelvic lymph node assessment in the premenopausal and postmenopausal groups, respectively (p=0.4) and paraaortic in 37.0% and 30.0% (p=0.19). There was no significant difference in stage distribution, grade differentiation, myometrial invasion or lymphovascular space invasion, between the two groups. The rate of administration of adjuvant chemotherapy was 15.6% in premenopausal and 13.8% in postmenopausal patients (p=0.75) and 28.9% and 37.9% (p=0.26) of adjuvant radiotherapy, respectively. According to these results, in our population, there was no significant difference in the favourable clinical prognostic factors in premenopausal women. The retrospective nature of the study and the small size of the cohort could justify these findings.