EPIDEMIOLOGICAL, CLINICAL, THERAPEUTIC AND EVOLUTIONARY ASPECTS OF ENDOMETRIAL CANCER: EXPERIENCE OF THE NATIONAL INSTITUTE OF ONCOLOGY OF RABAT (ABOUT 158 CASES)

Introduction and purpose of the study:Endometrial cancer is the third most common gynaecological cancer in Morocco. Its managementis multidisciplinary.

Materials and Methods:Our retrospective study concerned patients admitted to the National Institute of Oncology between January 1st 2014 and January 1st 2018. The data were collected using a data collection form where the epidemiological, clinical, therapeutic and evolutionary data were specified.

Results and Statistical Analysis:During this period, we collected 158 cases of endometrial cancer. The age of the patients at the time of diagnosis varied between 33 and 94 years, with a median age of 61 years. Our study shows that 83.5% of the patients were postmenopausal, 19% diabetic and 26.6% hypertensive. 84.8% of the patients consulted for postmenopausal metrorrhagia, 3.8% for menometrorrhagia and 1.9% for pelvic pain within an average of 7 months.Patients underwent Endometrial Biopsy orCurettage in 14.6% and 50.6% of cases, respectively 42.4% hadan endometrioid adenocarcinoma. 39.2% of the patients underwent pelvicMagnetic Resonance Imaging(MRI) and 32.3% pelvic CT. Therapeutically, the main treatment received after a multidisciplinary consultation meeting was surgery alone in 38% of cases, external radiotherapy followed by brachytherapy of the vaginal fundus in 22.8%. Acute toxicity was observed in 32.5% of cases, dominated by renal and haematological toxicities. The analysis of the surgical specimen allowed us to classify our patients into four FIGO( International Federation of Gynaecology and Obstetrics(stages, predominantly stage IB found in 32.9% of cases followed by stage IA in 27.8% of cases Lymph-vascular space invasion (LVSI)were positive in 14.6% of cases. 10.8% progression and 7% recurrence were observed during the follow-up.Overall survival (OS) at 1year was estimated at 88.3% 86.8% at 2 years and 86.1% at 5 years.

Conclusion:According to our study, the patients treated during this period in our institute are mostly postmenopausal, diagnosed at an early stage, essentially by surgery alone with an excellent survival rate. These results are consistent with the literature.