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Population-based cohort study of the effect of endometrial cancer classification and treatment criteria on long-term survival

Journal article
Authors Teresia Svanvik
Karin Sundfeldt
Ulf Strömberg
Erik Holmberg
J. Marcickiewicz
Published in International Journal of Gynecology & Obstetrics
Volume 138
Issue 2
Pages 183-189
ISSN 0020-7292
Publication year 2017
Published at Institute of Clinical Sciences, Section for Oncology, Radiation Physics, Radiology and Urology
Institute of Clinical Sciences, Section for the Health of Women and Children, Department of Obstetrics and Gynecology
Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Pages 183-189
Language en
Links doi.org/10.1002/ijgo.12214
Keywords Adjuvant therapy, Endometrial cancer, Relative survival, gynecologic-oncology-group, phase-iii trial, intermediate-risk, postoperative radiotherapy, adjuvant chemotherapy, randomized-trials, dna-ploidy, mrc astec, carcinoma, surgery, Obstetrics & Gynecology
Subject categories Clinical Medicine


Objective: To evaluate if increased individualization in endometrial cancer classification/treatment affected relative survival. Methods: The present retrospective register-based population study included data from all women in the western Swedish healthcare region who were treated for endometrial cancer between January 1, 1995, and December 31, 2011. Outcomes and prognostic data were retrieved from the western Swedish healthcare region's cancer and clinical endometrial cancer registries. Patients were stratified based on two different treatment programs (cohort 1 January 1, 1995, to September 10, 2006, and cohort 2 September 11, 2006, to December 31, 2011) and relative survival was compared. Results: Data from 4338 patients were included; 2936 in cohort 1 and 1402 in cohort 2. Among endometrioid endometrial carcinomas, the 5-year relative survival rate for did not differ significantly between the groups (P=0.751); radiotherapy was used more frequently in cohort 1 (P<0.001). Among non-endometrioid endometrial carcinomas, relative survival was lower in cohort 1 (P=0.006); radiotherapy use was more frequent in cohort 1 and chemotherapy use was more frequent in cohort 2 (P<0.001). Conclusion: Increased individualization in endometrioid endometrial cancer management did not improve relative survival. Improved relative survival was observed for non-endometrioid endometrial cancer; possibly due to increased adjuvant chemotherapy use.

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