Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?

VINKLEROVÁ, Petra, Petra OVESNÁ, Markéta BEDNAŘÍKOVÁ, Luboš MINÁŘ, Michal FELSINGER, Jitka HAUSNEROVÁ and Vít WEINBERGER. Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? Cancers. Basel: MDPI, 2022, vol. 14, No 1, p. 1-11. ISSN 2072-6694. Available from: https://dx.doi.org/10.3390/cancers14010115.

Basic information

• Original name: Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?
• Authors: VINKLEROVÁ, Petra (203 Czech Republic, belonging to the institution), Petra OVESNÁ (203 Czech Republic, belonging to the institution), Markéta BEDNAŘÍKOVÁ (203 Czech Republic, belonging to the institution), Luboš MINÁŘ (203 Czech Republic, belonging to the institution), Michal FELSINGER (203 Czech Republic, belonging to the institution), Jitka HAUSNEROVÁ (203 Czech Republic, belonging to the institution) and Vít WEINBERGER (203 Czech Republic, guarantor, belonging to the institution).
• Edition: Cancers, Basel, MDPI, 2022, 2072-6694.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30204 Oncology
• Country of publisher: Switzerland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 5.200
• RIV identification code: RIV/00216224:14110/22:00125126
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.3390/cancers14010115
• UT WoS: 000741365900001
• Keywords in English: endometrial cancer; postmenopausal bleeding; prognosis
• Tags: 14110212, 14110230, 14110411, 14119612, rivok
• Tags: International impact, Reviewed

Abstract

Background: Endometrial cancer is the most common gynecological malignancy in developed countries with no screening available. There is still a tendency to provide invasive bioptic verification in asymptomatic women with abnormal ultrasound findings to diagnose carcinoma in a preclinical phase; even though, it is not supported by European guidelines. Our goal was to determine DFS (disease-free survival), OS (overall survival), and DSS (disease-specific survival) differences between symptom-free and symptomatic (bleeding, or spotting) endometrial cancer patients with similar stage and tumor/clinical characteristics. Methods: All of our patients with endometrial cancer following surgical treatment between 2006 and 2019 were assessed, evaluating risk factors for recurrence and death while focusing on bleeding using univariable and multivariable analysis. Results: 625 patients meeting the inclusion criteria were divided into asymptomatic (n = 144, 23%) and symptomatic (n = 481, 77%) groups. The median follow-up was 3.6 years. Using univariable analysis, symptomatic patients had a three times higher risk of recurrence (HR 3.1 (95% Cl 1.24–7.77), p = 0.016). OS (HR 1.35 (0.84–2.19), p = 0.219) and DSS (HR 1.66 (0.64–4.28), p = 0.3) were slightly worse without reaching statistical significance. In our multivariable analysis, symptomatology was deemed completely insignificant in all monitored parameters (DFS: HR 2.03 (0.79–5.24), p = 0.144; OS: HR 0.72 (0.43–1.21), p = 0.216). Conclusions: The symptomatic endometrial cancer patients risk factor of earlier recurrence and death is insignificantly higher when compared with the asymptomatic cohort. However, multivariable analysis verifies that prognosis worsens with other clinically relevant parameters, not by symptomatology itself. In terms of survival outcome in EC patients, we recognized symptomatology as a non-significant marker for the patient’s prognosis.