Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective |
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Authors: | Trovik Jone Mauland Karen K Werner Henrica M J Wik Elisabeth Helland Harald Salvesen Helga B |
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Affiliation: | a Department of Obstetrics and Gynecology, Haukeland University Hospital, 5021 Bergen, Norwayb Department of Clinical Medicine, University of Bergen, Haukeland University Hospital, 5021 Bergen, Norway |
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Abstract: | ObjectiveAge adjusted incidence rate for uterine cancers in Norway has increased over last three decades from 12.2/100.000 (1981-90) to 16.0 (2001-2010). Corresponding 5-year survival increased nationally from 76.3% to 83.3%.MethodsWe wanted to investigate how changes in therapeutic strategies during a 30-year period are reflected in survival changes through careful characterization of a population-based series of 1077 endometrial carcinoma patients from Hordaland County, Norway.ResultsIn concordance with increase in endometrial cancer nationally, the number of patients treated from Hordaland County rose from 286 (1981-1990) through 307 (1991-2000) to 484 (2001-2010). Main treatment changes included increase in routine pelvic lymphadenectomy from 0% through 9% to 77%, adjuvant chemotherapy from 0% through 3% to 9% and a dramatic reduction in adjuvant radiotherapy from 75% through 48% to 12% (all P < 0.001). Body mass index increased significantly during this 30-year period, as did the 5-year disease-specific survival: from 75.8 through 80.2 to 86.9% (P = 0.002) and overall survival from 67.8 through 71.7 to 77.8% (P = 0.03).ConclusionImproved overall and disease specific survival for endometrial carcinoma patients over the last 30 years is demonstrated in a population-based setting. Increasing BMI among patients and a change in treatment strategy with reduction in adjuvant radiotherapy and more extensive surgery is demonstrated for the same period. |
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Keywords: | Endometrial cancer Survival Treatment modalities |
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