Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/1/115 |
| _version_ | 1797499427341991936 |
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| author | Petra Vinklerová Petra Ovesná Markéta Bednaříková Luboš Minář Michal Felsinger Jitka Hausnerová Vít Weinberger |
| author_facet | Petra Vinklerová Petra Ovesná Markéta Bednaříková Luboš Minář Michal Felsinger Jitka Hausnerová Vít Weinberger |
| author_sort | Petra Vinklerová |
| collection | DOAJ |
| description | 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 (<i>n</i> = 144, 23%) and symptomatic (<i>n</i> = 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), <i>p</i> = 0.016). OS (HR 1.35 (0.84–2.19), <i>p</i> = 0.219) and DSS (HR 1.66 (0.64–4.28), <i>p</i> = 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), <i>p</i> = 0.144; OS: HR 0.72 (0.43–1.21), <i>p</i> = 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. |
| first_indexed | 2024-03-10T03:47:12Z |
| format | Article |
| id | doaj.art-469461994fba4c5e92aefbc422d882ca |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:47:12Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-469461994fba4c5e92aefbc422d882ca2023-11-23T11:16:17ZengMDPI AGCancers2072-66942021-12-0114111510.3390/cancers14010115Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?Petra Vinklerová0Petra Ovesná1Markéta Bednaříková2Luboš Minář3Michal Felsinger4Jitka Hausnerová5Vít Weinberger6Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicInstitute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicDepartment of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicDepartment of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicDepartment of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicDepartment of Pathology, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicDepartment of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech RepublicBackground: 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 (<i>n</i> = 144, 23%) and symptomatic (<i>n</i> = 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), <i>p</i> = 0.016). OS (HR 1.35 (0.84–2.19), <i>p</i> = 0.219) and DSS (HR 1.66 (0.64–4.28), <i>p</i> = 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), <i>p</i> = 0.144; OS: HR 0.72 (0.43–1.21), <i>p</i> = 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.https://www.mdpi.com/2072-6694/14/1/115endometrial cancerpostmenopausal bleedingprognosis |
| spellingShingle | Petra Vinklerová Petra Ovesná Markéta Bednaříková Luboš Minář Michal Felsinger Jitka Hausnerová Vít Weinberger Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? Cancers endometrial cancer postmenopausal bleeding prognosis |
| title | Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? |
| title_full | Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? |
| title_fullStr | Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? |
| title_full_unstemmed | Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? |
| title_short | Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? |
| title_sort | does an endometrial cancer diagnosis among asymptomatic patients improve prognosis |
| topic | endometrial cancer postmenopausal bleeding prognosis |
| url | https://www.mdpi.com/2072-6694/14/1/115 |
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