The assessment of overall survival (OS) after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland

Abstract

Objectives: In 2013 malignant endometrial cancers have amounted to 7.3% of all cancers diagnosed among women in the report by the Polish National Cancer Registry Raw prevalence rate amounted to 28.7, whereas standardised prevalence rate 15.6 per 100 000 population. Among the causes of death, these cancers amounted to 3% and were ranked ninth on the list of the most common causes of oncologic mortality of women. In the year 2013 a total of 1243 women died of malignant endometrial cancers. A stable increase of malignant endometrial cancer incidence has been observed for 2 decades. Despite that fact, the increase of the mortality incidence is at a much lower level, which demonstrates the much higher effectiveness of the treatment of such cancers. The recording rate of the malignant endometrial cancer mortality amounts to 95%, so the presented absolute numbers are reliable. Examining the clinical stages of malignant endometrial cancers, we can establish that approx. 85% of them are diagnosed at stage I or II according to the FIGO classification. Patients with advanced stages of cancer represent less than 15%.Material and methods: retrospective analysis of endometrial body cancer prevalence data for the entire population of Poland, assessment of malignant endometrial cancer prevalence in the years 2008-2015 and overall survival probability in the population of patients undergoing adjuvant chemotherapy. Results:The number of patients with a diagnosed malignant endometrial cancer within the studied period in Poland remains on a stable level (2008 -30.6 thousand patients, 2015 -40.2 thousand patients). Among all listed patients with the indication of C54 each year approx. 20% enters hospital treatment. System therapy with chemotherapy drugs was used in approx. 1-2% of patients treated in hospitals. The average age of the patients was 64.9 years, and the median age 65 years. The number of observations was 2085, including 1088 censored observations. The average survival for the sample under study was 30.67 month (SD = ± 0.6); median survival time was 23.93 month. The number of censored observations was 1088 (52.16%). Probable survival of 1 year is achieved by 67.57% of patients, 2 years by 49.73%, 3 years by 40.68%, above 5 years 30.77%. Conclusions:The incidence of endometrial cancer in Poland in the years 2008-2015 continues to grow at 5% upward trend (in Europe 3.4-5.9). In Poland in 2012, crude incidence rate for cancer of the uterus was 29.8 and did not differ significantly from the results in countries such as Finland, Slovakia, Sweden, Belgium and Bulgaria. The overall survival after adjuvant chemotherapy for patients with malignant endometrial cancer in Poland shows considerable differences depending on the region of the country.

Integrated analysis of genome-wide DNA methylation and cancer-associated fibroblasts identified prognostic biomarkers and immune checkpoint blockade in lower grade gliomas

“…Mutations in IDH1 characterize the majority of lower-grade gliomas in adults and define a subtype associated with a favorable prognosis ( 58 , 59 ). Glioma shows a markedly elevated mutation burden, referred to as TMB-H ( 60 ). A study suggests that some gliomas with high TMB may benefit from PD-1 blockade therapy ( 61 ).…”

Association of intrauterine synechiae with pituitary gonadotrophin pulse patterns: A pilot study

“…Hypoestrogenism leading to reduced endometrial re-epithelialization facilitates the appearance of adhesions [12,[24][25][26]. Changes in ovarian function have been observed in the presence of intrauterine adhesion, leading to anovulation and hypoestrogenism [16,18,[25][26][27]. However, we found that estradiol levels in the Asherrman participants were lower than those in the control patients.…”

“…Serum LH and FSH levels have been shown to be within normal limits in these patients [15]. However, functional changes in the hypothalamic-pituitary system of patients with IS were reported by Teter et al [16]. In 1987, Halbe et al [17] suggested neural involvement to explain the finding of an LH/FSH ratio greater than two in patients with canalicular amenorrhea.…”

The struggle against endometrial cancer: ten years of experience of a tertiary center

“…Approximately, 3850 new cases are reported annually and around 520 deaths linked to endometrial cancer are seen in Turkey [2]. Most of the patients are diagnosed at an early stage (80% Stage 1) and the average age at the time of diagnosis is reported to be 63 [3]. The incidence of EC is increasing due to various factors such as increased prevalence of obesity, decreased menopausal hormone therapy with progestins, increased prevalence of diabetes and changes in reproductive behavior (increased prevalence of nulliparity, etc.)…”