title: Thirty-day postoperative mortality for endometrial carcinoma in England: a population-based study.
abstract: OBJECTIVE
  To quantify trends in 30-day mortality following surgery for endometrial carcinoma in England, and investigate hospital- and geographical-level variations.
  
  
  METHODS
  Retrospective population-based observational study using cancer registration and Hospital Episodes Statistics data.
  
  
  METHODS
  England.
  
  
  METHODS
  Women diagnosed with endometrial carcinoma (ICD10 C54-C55 excluding sarcomas and malignant mixed Mullerian tumours) between 2000 and 2009 who were treated surgically (n = 38 332).
  
  
  METHODS
  Random effects logistic regression model of postoperative mortality rates, adjusting for patient- and/or tumour-level factors (namely age, income deprivation, year of diagnosis, FIGO stage and grade). Case-mix adjusted postoperative mortality rates for hospitals and cancer networks were derived from the model. Multiple imputation was used to account for missing stage and grade data.
  
  
  METHODS
  30-day postoperative mortality rate.
  
  
  RESULTS
  For 2000-2009, the percentage of women dying within 30 days of surgery for endometrial carcinoma was very low at 0.61% (235 deaths), and decreased from 0.70% in 2000-2001 to 0.48% in 2008-2009. Postoperative mortality rates were lower for laparoscopic surgery, and higher for older women, those with advanced stage disease and high-grade tumours. Crude and case-mix adjusted results indicated that one hospital had a higher postoperative mortality rate than expected.
  
  
  CONCLUSIONS
  The postoperative mortality rate for endometrial carcinoma in England is low and has improved since 2000, with increasing use of laparoscopic surgery. Postoperative mortality rates differed by surgical approach, patient age, disease stage and tumour grade. Only one hospital had a higher postoperative mortality rate than expected after adjusting for patient case-mix.
  
  
  CONCLUSIONS
  More women with endometrial cancer but better 30-day survival after surgery since 2000.
authors.affiliation: National Cancer Intelligence Network, Public Health England, Sheffield, UK. carolynn.gildea@phe.gov.uk.
authors.forename: C
authors.initials: C
authors.lastname: Gildea
authors.affiliation: East Kent Gynaecological Centre, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: A
authors.initials: A
authors.lastname: Nordin
authors.affiliation: Department of Cellular Pathology, Birmingham Women's NHS Trust, Birmingham, UK.
authors.forename: L
authors.initials: L
authors.lastname: Hirschowitz
authors.affiliation: National Cancer Intelligence Network, Public Health England, Sheffield, UK.
authors.forename: J
authors.initials: J
authors.lastname: Poole
mesh_terms: D000367:Age Factors; D000368:Aged; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D004739:England; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000401:mortality*; D016015:Logistic Models; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011184:Postoperative Period; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Endometrial carcinoma; postoperative mortality; trends; variations