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Endometrial Cancer in Oman , A Single Institution Experience

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ESGO State of the Art 2018 Conference

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Abstract

Introduction: Endometrial cancer is the most common gynecologic malignancy worldwide. Most endometrial cancers are diagnosed at an early stage (75%), and hence the reported survival rate is 75%. In Oman, uterine cancer is the commonest gynecologic cancer. To date no data is available about this cancer in the country. Objectives: This is a retrospective cohort study to evaluate the patient’s characters, pathological types, treatment given, outcome and recurrence of uterine cancer among Omani patients. This will help in planning the diagnostic and therapeutic strategies and organization of health care resources . Methods: All patients who were diagnosed with uterine cancer between January 2006 and December 2014 were identified from the Hospital database and their data were collected. Information were gathered on patients characteristics including age, BMI, parity and risk factors. Information were gathered on tumor characteristics including histo-pathological subtypes, stage and grade. The different modalities of treatment delivered for the patients including surgery, radiotherapy, chemotherapy or hormonal therapy were analyzed. The recurrence of the disease with different sites and treatment given were obtained. Data analysis was done by SPSS version 17 and epi info. Results: This study showed our institutional experience with Omani patients diagnosed with uterine malignancy. Eighty eight patients with uterine cancer were identified. The mean age of the patients was 60.9 ± 12.5 years, the mean body mass index ± SD was 31.4 ± 8.0 kg/m2, and the median parity was approximately 7.0. Although diabetes and hypertension are considered independent risks factors, we found that 25 patients (28.4%) were diabetic while 41 patients (46.6%) were hypertensive. Type 1 endometrial cancer was diagnosed in 44% of patients , while type 2 was diagnosed in 56% of patients. Tumor distribution by International Federation of Gynecology and Obstetrics stage was the following: 39 patients (44.3%) had stage I disease at diagnosis, 12 patient (13.6%) stage II disease, 22 patients (25.4%) stage III disease, 4 patients (4.5%) stage IV disease. The surgical treatment was the main treatment performed for 77 patients (87.5%). Adjuvant chemotherapy was given for 21 patients (23.7%) and adjuvant radiotherapy for 39 patients (44.3%). Hormonal therapy was given for 5 patients (5.7%). Twenty two patients (25%) had a recurrence of the disease at different sites on follow up. Only two patients (9.1%) had local recurrence while majority (13 patients , 59.1%) had recurrence at different sites including peritoneum , bones , brain and lymph nodes. Treatment of recurrence consisted mainly of chemotherapy (13/22=59.1%) , hormonal treatment ( 4/22=18.1%), surgical resection (2/22=9.1%) and radiotherapy (1/22=4.5%). Combined modality treatment (2/22=9.1%) . Conclusions: Endometrial cancer in Oman was diagnosed at early stages (51/88 patients = 57.9%). Despite that multi-parity are proven to be protective against type 1 endometrial cancer, it was not protective against type 2 as most of the patients developed mainly type 2 endometrial cancer (42/75= 56%). Majority of patients had surgery (77/88 =87.5%) with either adjuvant radiotherapy or chemotherapy. This explained why only 25% (22/88 patients) had relapsed disease after treatment. Thus uterine cancer is one of the cancer in Omani population that can be diagnosed and treated at an early stage with good results.

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