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. 2024 May 27;150(5):279.
doi: 10.1007/s00432-024-05772-9.

Treatment of endometrial cancer from 2000 to 2020 in Germany: a retrospective population based cohort study

Thomas Papathemelis #  1   2 , Olaf Ortmann #  3 , Cynthia Kohl  4 , Petra Neuser  5 , Kees Kleihues-van Tol  6 , Monika Klinkhammer-Schalke  7 , Peter Ugocsai  3 , Christina Barbara Walter  8 , Miriam Rottmann  9 , Catherine Real  10 , Christina Justenhoven  11 , Gabriele Robers  12 , Constanze Schneider  13 , Michael Gerken  7 , Andrea Sackmann  5 , Soo-Zin Kim-Wanner  5
Affiliations

Treatment of endometrial cancer from 2000 to 2020 in Germany: a retrospective population based cohort study

Thomas Papathemelis et al. J Cancer Res Clin Oncol. .

Abstract

Purpose: Endometrial cancer (EC) is one of the most common malignancies among women in western countries. This study aimed to assess data on patient treatment in Germany throughout two decades to evaluate the development and effect of surgery, radiation, and chemotherapy.

Methods: This retrospective registry study included 34,349 EC patients diagnosed between 2000 and 2020. Patients were classified into five risk groups. Overall survival was analyzed by Kaplan-Meier method as well as univariable and multivariable Cox regression to evaluate risk factors and treatment options.

Results: Over the study period, minimal invasive surgery was used more often compared to open surgery and was associated with better overall survival. Patients with advanced EC were more likely to receive multimodal therapy. Patients with intermediate risk EC had a good prognosis upon surgery, which further improved when radiotherapy was added. High-risk patients showed poorer prognosis but clearly benefited from additional radiotherapy. Survival of elderly high-risk patients with a non-endometrioid histology was improved when chemotherapy was added to surgery and radiotherapy.

Conclusion: Our study includes a large analysis of data from German clinical cancer registries on the care of endometrial cancer during two decades. We observed an increase of minimal invasive surgery. There is evidence that minimal invasive surgery is not inferior to open surgery. Adjuvant radio- and chemotherapy further improves survival depending on risk group and age.

Keywords: Chemotherapy; Multimodal therapy; Outcome; Overall survival; Radiotherapy; Retrospective cohort study; Surgery.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of patient selection criteria for evaluation of surgical approaches and adjuvant therapy in this study
Fig. 2
Fig. 2
Surgical approach impact on overall survival. a Number of EC patients who were subjected to different surgical approaches per year of diagnosis. b Impact of surgical approach on overall survival over five years after diagnosis
Fig. 3
Fig. 3
Overall survival for intermediate risk patients who received surgery with or without radiotherapy (SX surgery, RT radiotherapy)
Fig. 4
Fig. 4
Overall survival of high-risk EC patients of less than 70 years of age (a), over 70 years of Age (b), with non-endometrioid subtype (c), endometrioid subtype (d), without nodal involvement (e) and with nodal involvement (f), who underwent surgery with or without adjuvant therapies. SX surgery, RT radiotherapy, RCT radiochemotherapy
Fig. 4
Fig. 4
Overall survival of high-risk EC patients of less than 70 years of age (a), over 70 years of Age (b), with non-endometrioid subtype (c), endometrioid subtype (d), without nodal involvement (e) and with nodal involvement (f), who underwent surgery with or without adjuvant therapies. SX surgery, RT radiotherapy, RCT radiochemotherapy
See this image and copyright information in PMC

References

    1. Abu-Rustum NR, Zhou Q, Iasonos A, Alektiar KM, Leitao MM, Chi DS, Sonoda Y, Soslow R, Hensley M, Barakat RR (2011) The revised 2009 FIGO staging system for endometrial cancer: should the 1988 FIGO stages IA and IB be altered? Int J Gynecol Cancer 21:511–516. 10.1097/IGC.0b013e31820cc305 - PMC - PubMed
    1. Åkesson Å, Adok C, Dahm-Kähler P (2023) Recurrence and survival in endometrioid endometrial cancer: a population-based cohort study. Gynecol Oncol 168:127–134. 10.1016/j.ygyno.2022.11.012 - PubMed
    1. Arnold M, Pandeya N, Byrnes G, Renehan AG, Stevens GA, Ezzati M, Ferlay J, Miranda JJ, Romieu I, Dikshit R, Forman D, Soerjomataram I (2015) Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol 16:36–46. 10.1016/S1470-2045(14)71123-4 - PMC - PubMed
    1. Bock N, Vordermark D, Emons G (2018) Endometriumkarzinom. Onkologe 24:177–188. 10.1007/s00761-017-0316-5
    1. Chen T, Jansen L, Gondos A, Ressing M, Holleczek B, Katalinic A, Brenner H (2012) Survival of endometrial cancer patients in Germany in the early 21st century: a period analysis by age, histology, and stage. BMC Cancer 12:128. 10.1186/1471-2407-12-128 - PMC - PubMed

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