Short and long-term outcomes of endometrial cancer and atypical endometrial hyperplasia management in young women

Abstract

Objecitve: The incidence of endometrial cancer in young women is increasing. Since survival after management is in most cases excellent, the focus on long-term patient reported outcomes (PROs) is crucial. Herein we examine the characteristics and oncological and reproductive outcomes of young women with endometrial cancer. Methods: We have identified all women under 45 years of age treated at the University Medical Centre Maribor between the years 2008–2020. Women were contacted to evaluate the endometrial cancer specific PROs using the EORTC QLQ-EN24 questionnaire. Results: Endometrial cancer and atypical endometrial hyperplasia were diagnosed in women younger than 45 years in 5.1% women and in 5.3% women respectively. Fourteen women (44%) under 45 years were eligible for fertility sparing procedures and only 6 of them (43%) opted for this approach. Women who opted for fertility sparing procedures were significantly younger (p < 0.001) with a median age of 31.0 (29–35) versus 42.5 years (34–45) in women opting for standard treatment. A significant proportion of women opting for fertility sparing treatment (67%) were nulliparous (p < 0.014) at time of diagnosis. Considering PROs, a high level of reported back/pelvic pain and tingling/numbness in the limbs was reported in our group of women. Conclusions: Young women with endometrial cancer should be offered counselling on the possibility of fertility sparing procedures. Future research should focus on long term PROs and mechanisms of improving them.