Clinicopathologic Characteristics, Management Out Come and its Associated Factors Among Patients Managed with Uterine Cancer in Tikur Anbessa Specialized Hospital: Addis Ababa Ethiopia: A Retrospective Cohort Study
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Date
2024-08-11
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Addis Ababa University
Abstract
Background: -: Most cases of endometrial cancer are found at early stage and have a good
outcome overall. But about one-third of patients had a diagnosis of advanced disease. Patients
who report with advanced stage or aggressive histologic subtypes have a higher rate of
recurrence and, consequently, lower survival times, despite favorable outcomes in early-stage
cancer. Over the last 20 years, the number of deaths from EC has climbed by more than 100%,
with type II EC accounting for up to 40% of cases. The type of treatment was linked to a 36%
lower chance of mortality or relapse. Since there is no studies that evaluate the treatment
outcome of uterine cancer in our country this study was conducted.
Objective: -To assess Clinicopathologic characteristics, management outcome and its associated
factors among patients with uterine cancer treated at Tikur Anbessa specialized Hospital: A five
years retrospective cohort study, 2024.
Method; - Facility based retrospective cohort study design was conducted. Using a 2 months
study period a five years data was recruited. 128 uterine cancer cases managed at TASH from
Jan 1st 2015 to Dec 30th 2019 were involved. Data was gathered through the perusal of patient
charts. Collected data was checked for completeness, consistency, clarity, and missed values and
was entered into SPSS version 25 for data management and further statistical analysis. The
clinicopathologic characteristic were described using symptoms, signs, and pathological findings
related to a specific disease or condition. The management outcome was measured using logistic
regression.. 95% confidence intervals were used to correlate the outcome variable with its
independent variable. The threshold for statistical significance was established at p-value < 0.05
for all tests.
Result: - In this study 128 charts were reviewed and out of this 59(46.1%) of the study
participants were in the age group 51-65 years with a mean and SD of 55.5±9.3 years
respectively. 117(91.4%) of the participants were menopause and 64(50%) of the participants
had presenting signs and symptoms of vaginal bleeding only and 37(28.9%) had vaginal bleeding
and discharge. 53(41.4%) of the study participants had a symptom of 6-12 months duration and
19(14.8%) of the participants had ascites based on imaging. The study found that great majority
(87.5%) of uterine cancer cases were endometrial cancer, and the rest is smooth muscle and
mesenchymal cancer. The average age at diagnosis was 56 and 54 respectively. Metastasis
occurred in 20.3% of cases, predominantly in the peritoneum (19.2%). Recurrent metastases
were observed in 33 patients, with 57.6% having both distant and local metastases. During the
final follow up from 128 cancer cases 22% were were died. The determinant factor of patient
death at last hospital follow up outcome were age of >60 years (AOR=1.3, 95%CI=1.11, 16.37),
having metastasis (AOR=3.1, 95%CI=1.21, 7.69), tumor size of >2cm (AOR=1.4, 95%CI=1.18,
10.33) and provisional FIGO stage IV (AOR=16.3, 95%CI=1.23, 32.45).
Conclusion and recommendation-
The study found that great majority (87.5%) of uterine
cancer cases were endometrial cancer, and the average age at diagnosis was 56 and 54
respectively. Recurrent metastases were observed in 33 patients, with 57.6% having both distant
and local metastases. During the final follow up from 128 cancer cases 22% were were died.Old
age, metastasis, increasing tumor size and increasing the stage of disease are statistically
significant factor for the death of the study participants. Further study is needed to address the
final outcome of patients.
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Keywords
clinicopathologic, treatment outcome, uterine cancer, time of death