الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 73 |  |  |
| | | from | 73 | | |
Abstract
Endometrial cancer (EC) is one of the most common gynecological cancers. The leading treatment option for EC is abdominal hysterectomy, together with removing of the Fallopian tubes and ovaries on both sides. In more advanced patients, radiotherapy, chemotherapy or hormone therapy may also be recommended. If the disease is diagnosed earlier, the outcome is favorable.
Here this work aimed to examine time free disease of patients with advanced endometrial cancer underwent upfront surgery at El Shatby Maternity University hospital.
This study was a cross sectional observational conducted on 28 patients diagnosed with advanced endometrial cancer FIGO stage III/IV from January 2020 to December 2021.
In the current study, the patients age ranged from 38 to 77 years with mean value of 62.54 ± 8.15 years. BMI ranged from 26 to 40 kg/m2 with mean value 35.18 ± 4.80 kg/m2.
The most common medical history was hypertension that represented 60.7% of the cases followed by diabetes 21.4% of cases. 42.9 % of the studied patients does not have any surgical history followed by 21.4% have D&C followed by 10.7 have hernia repair.
The commonest site of metastasis was para-aortic LN (28.6%) followed by the serosa of the uterus (17.9%). According to FIGO system, our patients were classified into stage III (82.1%) and stage IV (17.7%). The most common stage was stage IIIA that represent 46.4% followed by stage IIIC 32.1%.
Complete cytoreduction (R0) was performed in 57.1% of cases and 42.1% of cases have incomplete cytoreduction (R1).
Regarding the postoperative histopathology findings in the current work, 64.3% was type I and 35.7% was type II and the most common histopathological type was endometrioid 64.3% followed by sarcoma 21.4%. Most of tumors (64.3%) were moderately differentiated (grade II).
Time free disease after surgery ranged from 6 months up to 2 years with a mean of 1.26 ± 0.45 years. In addition, recurrence was reported only in 35.7% of cases at the time of the follow up (1 year after surgery) mostly at the vaginal vault. According to survival, 71.4% of cases survived with a mean time of 126 ± 0.45 and 28.6 of cases died at the following up year (1year after surgery).
We found statistically significant relations between disease free survival time with type of surgery either complete or incomplete cytoreduction and histopathology type of the tumor. While there were no statistically significant relations between disease free survival time with tumor grade and histopathological subtypes.
Also, there statistically significant relations between overall survival with type of surgery and histopathology type of the tumor. While no statistically significant relations were reported between overall survival with tumor grade and histopathological subtypes.
There were no statistically significant relations between type of surgery with age, BMI, medical or surgical history, site of the metastasis, histopathological subtypes and tumor grade.
On the other hand, there were statistically significant relations between type of surgery with FIGO staging, histopathological type of the tumor, tumor recurrence and the survival of the cases.
Univariate and Multivariate regression analysis showed that FIGO staging is the most important factor affecting the disease-free survival time with univariate p=0.217 followed by histopathological type of the tumor with univariate p=0.083 and multivariate p=0.880 followed by type of the procedure with univariate p=0.082 and multivariate p= 0.915.
Also, univariate and Multivariate regression analysis revealed that the type of the procedure is the most important factor affecting the overall Survival with univariate p=0.029 and multivariate p=0.215 followed by the histopathological type of the tumor with univariate p=0.069 and multivariate p=0.560 followed by FIGO staging of the cases with univariate p=0.010 and multivariate p=0.942.