Impact of patient characteristics on primary treatment approach of endometrial cancer: a population-based study in the Netherlands.

IF 4.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Heidi Rütten, Hans H B Wenzel, Mieke Ten Eikelder, Michiel Simons, Maaike A van der Aa, Johan Bussink, Johanna M A Pijnenborg
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引用次数: 0

Abstract

Objective: The incidence of endometrial cancer is rising worldwide, with increasing numbers of elderly patients with substantial comorbidity. We aimed to provide insight into the primary treatment strategies, trends, and outcomes for patients with endometrial cancer in the Netherlands across different periods, and to evaluate the influence of patient characteristics on treatment approaches within these periods.

Methods: All patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I to III endometrial cancer between 1995 and 2022 were identified in the Netherlands Cancer Registry. Data on histology, FIGO stage, primary treatment, Charlson comorbidity index, body mass index, and outcome were collected and analyzed. Patients were evaluated in 6 5-year cohorts to observe possible trends in treatment choices and outcomes over time, based on patient and tumor characteristics.

Results: A total of 43,443 patients were included. Most patients were diagnosed with endometrioid histology (89%, n = 38,751) and early-stage disease (FIGO I-II, 87%, n = 38,077). An increase in endometrial cancer incidence and survival was observed over time, along with a shift toward more non-endometrioid endometrial cases. A primary surgical approach was performed in 95% (n = 41,107) of patients. Among those receiving non-surgical management, curative treatment was reported in only 4% (n = 88). Most patients unfit for surgery either received no treatment (n = 1053, 2%) or were treated with hormonal therapy (n = 840, 2%). Over time, we observed increased use of hormonal therapy as a non-surgical treatment. Patients who did not undergo surgery were older, more often had a body mass index >30 kg/m2, and more often had a Charlson comorbidity index ≥2.

Conclusions: Incidence and survival in patients with endometrial cancer increased between 1999 and 2022. Patients unfit for surgery most often received no treatment or palliative hormonal therapy. Curative radiotherapy is not often used in patients unfit for surgery and should be considered for this group of patients.

患者特征对子宫内膜癌主要治疗方法的影响:荷兰一项基于人群的研究。
目的:子宫内膜癌的发病率在全球范围内呈上升趋势,伴随大量合并症的老年患者越来越多。我们旨在深入了解荷兰不同时期子宫内膜癌患者的主要治疗策略、趋势和结果,并评估这些时期患者特征对治疗方法的影响。方法:1995年至2022年间,所有被诊断为国际妇产科学联合会(FIGO) I至III期子宫内膜癌的患者在荷兰癌症登记处被确定。收集并分析组织学、FIGO分期、初始治疗、Charlson合并症指数、体重指数和结局的数据。患者分为6个5年队列进行评估,以观察基于患者和肿瘤特征的治疗选择和结果随时间的可能趋势。结果:共纳入43443例患者。大多数患者被诊断为子宫内膜样组织学(89%,n = 38,751)和早期疾病(FIGO I-II, 87%, n = 38,077)。随着时间的推移,观察到子宫内膜癌发病率和生存率的增加,同时转向更多的非子宫内膜样子宫内膜病例。95% (n = 41,107)的患者接受了初级手术入路。在接受非手术治疗的患者中,只有4% (n = 88)得到了治愈。大多数不适合手术的患者要么没有接受治疗(n = 1053,2%),要么接受激素治疗(n = 840,2%)。随着时间的推移,我们观察到激素治疗作为非手术治疗的使用增加。未接受手术的患者年龄较大,体重指数≥30 kg/m2的患者较多,Charlson合并症指数≥2的患者较多。结论:子宫内膜癌患者的发病率和生存率在1999年至2022年间有所增加。不适合手术的患者通常不接受治疗或姑息性激素治疗。治疗性放疗不常用于不适合手术的患者,应考虑对这类患者进行放疗。
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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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