Abstract
To study the epidemiological, clinical, paraclinical and therapeutic caracteristics of this cancer in south Tunisia population, a retrospective descriptive and analytic study was conducted over a period of 12 years from January 1993 until December 2004 on 52 patients carrying endometrial cancer. Diagnosis and therapeutic management were made in the departments of Obstetrics and Gynecology University Hospital HediChaker of Sfax and radiotherapy at the University Hospital Habib Bourguiba of Sfax. The average age of patients was 57.53 years. Menopause was observed in 76.92% cases. Hypertension, obesity and diabetes were observed, respectively, in 40.38%, 26.92% and 11.53% of cases. The mean delay of consulting was 8 months. Uterine bleeding was observed in 98.07% cases. Endometrial b iopsy curettage or directed biopsy was performed in 50 women (96.15%) including 35 women under hysteroscopy. Histopathological examination was conclusive in 46 patients (92%) Adenocarcinoma was the most frequent histological type found in 39 cases (84.78%). Physical examination under general anesthesia was carried out for 44 patients it was normal in 77.27% of cases. The magnetic resonance imaging was performed in 3 patients. Stage I and II were the most observed stages. Preoperative brachytherapy was achieved only in 30 women. Surgery was indicated in 49 cases (94.23%). Thirty three patients (63.46%) received supplemental external radiotherapy. Overall survival at 5 years was 66.8%. Endometrial cancer in associated with many risk factors it must be evoked in front of any abnormal bleeding in aged women. Endometrial biopsy curettage performed under hysteroscopy allows the diagnosis in most cases. Magnetic resonance imaging allows tumorstaging. Treatment is based on the triade brachytherapy, surgery and external post operative radiotherapy. Chemotherapyis added in the therapeutic arsenal in high recidive risk tumor.
Highlights
Endometrial cancer is a malignant tumor originating at the level of the uterine lining
A pre therapy locoregional and distance staging is achieved with an examination under general anesthesia, a Magnetic Resonance Imaging (MRI) or an abdominopelvic Computed Tomodensitometry (CT), chest radiography, abdominopelvic ultrasonography, cystoscopy, proctoscopy andtumor markers requested in the presence of associatedadnexal mass
The occurrence in a young woman of the endometrial cancer is often associated with other risk factors involving nulliparity, obesity, diabetes, gonadal dysgenesis, or Lynch syndrome II
Summary
Endometrial cancer is a malignant tumor originating at the level of the uterine lining. It represents the 3rd cancer in women after breast cancer and colorectal cancers. The typical age-incidence curve for endometrial cancer shows that most cases are diagnosed after the menopause. It is a hormono dependingcancer and exogenous or endogenous hyper oetrogenia is the main risk factor. The diagnosis of this cancer is based on histological analysis. It is often done in the early stages, prognosis is usually favorable.
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