Improved survival related to changes in endometrial cancer treatment, a 30-year population based perspective.
OBJECTIVE
Age 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%.


METHODS
We 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.


RESULTS
In 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).


CONCLUSIONS
Improved 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.
Department of Obstetrics and Gynecology, Haukeland University Hospital, 5021 Bergen, Norway. jone.trovik@helse-bergen.no
Jone
J
Trovik
Karen K
KK
Mauland
Henrica M J
HM
Werner
Elisabeth
E
Wik
Harald
H
Helland
Helga B
HB
Salvesen
D000368:Aged; D015992:Body Mass Index; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends