Treatment delay in endometrial cancer.

Abstract

TO THE EDITOR: I read with great interest the population-based study entitled “Impact of Wait Times on Survival for Women With Uterine Cancer” by Elit et al in the January 1 issue of Journal of Clinical Oncology. The authors concluded that longer wait times from diagnosis to surgery have a negative impact on survival. However, in this study, almost 23% of the patients had histological types of endometrial cancer (clear-cell carcinoma, serous carcinoma, adenosquamous carcinoma, and sarcoma) that are known to behave differently than endometrial endometrioid carcinoma and also known to have a unfavorable prognosis. In contrast, our study, cited by the authors, that found that a delay had no impact on prognosis, included only patients with endometrial endometrioid carcinoma. Our findings are also supported by several other studies. Indeed we reported a prolonged survival in a small series of untreated patients with endometrial endometrioid cancer and patients with a prolonged treatment delay. This seems to indicate that the natural progression course, even in untreated patients, may be slow in endometrial endometrioid carcinoma with favorable prognostic factors. Joseph Menczer Edith Wolfson Medical Center, Holon; Tel Aviv University, Tel Aviv, Israel