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Article

Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?

1
Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic
2
Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic
3
Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic
4
Department of Pathology, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic
*
Author to whom correspondence should be addressed.
Academic Editors: Miguel Abal and Laura Muinelo-Romay
Cancers 2022, 14(1), 115; https://doi.org/10.3390/cancers14010115
Received: 7 December 2021 / Revised: 21 December 2021 / Accepted: 24 December 2021 / Published: 27 December 2021
(This article belongs to the Special Issue Diagnosis and Management of Endometrial Cancer)
Endometrial cancer is common malignancy with an excellent prognosis due to its early symptoms—abnormal bleeding. It is still common in some countries to provide a biopsy in asymptomatic patients based on ultrasound findings; even though, it is not supported by the European guidelines. The aim of our study was to find out if there is a prognostic difference among symptomatic and bleeding-free patients with similar clinical histological characteristics.
Background: Endometrial cancer is the most common gynecological malignancy in developed countries with no screening available. There is still a tendency to provide invasive bioptic verification in asymptomatic women with abnormal ultrasound findings to diagnose carcinoma in a preclinical phase; even though, it is not supported by European guidelines. Our goal was to determine DFS (disease-free survival), OS (overall survival), and DSS (disease-specific survival) differences between symptom-free and symptomatic (bleeding, or spotting) endometrial cancer patients with similar stage and tumor/clinical characteristics. Methods: All of our patients with endometrial cancer following surgical treatment between 2006 and 2019 were assessed, evaluating risk factors for recurrence and death while focusing on bleeding using univariable and multivariable analysis. Results: 625 patients meeting the inclusion criteria were divided into asymptomatic (n = 144, 23%) and symptomatic (n = 481, 77%) groups. The median follow-up was 3.6 years. Using univariable analysis, symptomatic patients had a three times higher risk of recurrence (HR 3.1 (95% Cl 1.24–7.77), p = 0.016). OS (HR 1.35 (0.84–2.19), p = 0.219) and DSS (HR 1.66 (0.64–4.28), p = 0.3) were slightly worse without reaching statistical significance. In our multivariable analysis, symptomatology was deemed completely insignificant in all monitored parameters (DFS: HR 2.03 (0.79–5.24), p = 0.144; OS: HR 0.72 (0.43–1.21), p = 0.216). Conclusions: The symptomatic endometrial cancer patients risk factor of earlier recurrence and death is insignificantly higher when compared with the asymptomatic cohort. However, multivariable analysis verifies that prognosis worsens with other clinically relevant parameters, not by symptomatology itself. In terms of survival outcome in EC patients, we recognized symptomatology as a non-significant marker for the patient’s prognosis. View Full-Text
Keywords: endometrial cancer; postmenopausal bleeding; prognosis endometrial cancer; postmenopausal bleeding; prognosis
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MDPI and ACS Style

Vinklerová, P.; Ovesná, P.; Bednaříková, M.; Minář, L.; Felsinger, M.; Hausnerová, J.; Weinberger, V. Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? Cancers 2022, 14, 115. https://doi.org/10.3390/cancers14010115

AMA Style

Vinklerová P, Ovesná P, Bednaříková M, Minář L, Felsinger M, Hausnerová J, Weinberger V. Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis? Cancers. 2022; 14(1):115. https://doi.org/10.3390/cancers14010115

Chicago/Turabian Style

Vinklerová, Petra, Petra Ovesná, Markéta Bednaříková, Luboš Minář, Michal Felsinger, Jitka Hausnerová, and Vít Weinberger. 2022. "Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?" Cancers 14, no. 1: 115. https://doi.org/10.3390/cancers14010115

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