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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(02): 137-144
DOI: 10.1055/s-0040-1718434
Original Article
Oncology

Malignant Uterine Neoplasms Attended at a Brazilian Regional Hospital: 16-years Profile and Time Elapsed for Diagnosis and Treatment

Neoplasias malignas do útero atendidas em hospital regional brasileiro: Perfil em 16 Anos e tempo dispendido até diagnóstico e tratamento
Elaine Cristina Candido 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Nelio Neves Veiga Junior 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Monique Possari Minari 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Maria Carolina Szymanski Toledo 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Daniela Angerame Yela 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Julio Cesar Teixeira 
1   Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Abstract

Objective The present study aims to evaluate the profile of endometrial carcinomas and uterine sarcomas attended in a Brazilian cancer center in the period from 2001 to 2016 and to analyze the impact of time elapsed from symptoms to diagnoses or treatment in cancer stage and survival.

Methods This observational study with 1,190 cases evaluated the year of diagnosis, age-group, cancer stage and histological type. A subgroup of 185 women with endometrioid histology attended in the period from 2012 to 2017 was selected to assess information about initial symptoms, diagnostic methods, overall survival, and to evaluate the influence of the time elapsed from symptoms to diagnosis and treatment on staging and survival. The statistics used were descriptive, trend test, and the Kaplan-Meier method, with p-values < 0.05 for significance.

Results A total of 1,068 (89.7%) carcinomas (77.2% endometrioid and 22.8% non-endometrioid) and 122 (10.3%) sarcomas were analyzed, with an increasing trend in the period (p < 0.05). Histologies of non-endometrioid carcinomas, G3 endometrioid, and carcinosarcomas constituted 30% of the cases. Non-endometrioid carcinomas and sarcomas were more frequently diagnosed in patients over 70 years of age and those on stage IV (p < 0.05). The endometrioid subgroup with 185 women reported 92% of abnormal uterine bleeding and 43% diagnosis after curettage. The average time elapsed between symptoms to diagnosis was 244 days, and between symptoms to treatment was 376 days, all without association with staging (p = 0.976) and survival (p = 0.160). Only 12% of the patients started treatment up to 60 days after diagnosis.

Conclusion The number of uterine carcinoma and sarcoma cases increased over the period of 2001 to 2016. Aggressive histology comprised 30% of the patients and, for endometrioid carcinomas, the time elapsed between symptoms and diagnosis or treatment was long, although without association with staging or survival.

Resumo

Objetivo O presente estudo avaliou o perfil dos carcinomas endometriais e sarcomas uterinos atendidos em um centro brasileiro de câncer no período de 2001 a 2016, e avaliou o impacto do tempo decorrido entre os sintomas até o diagnóstico ou tratamento no estadiamento e sobrevida pelo câncer.

Métodos Estudo observacional com 1.190 casos que analisou o ano do diagnóstico, faixa etária, estágio e tipo histológico do câncer. Um subgrupo de 185 mulheres com histologia endometrioide e atendidas no período de 2012 a 2017 foi selecionado para avaliar informações sobre sintomas iniciais, métodos de diagnóstico, sobrevida global e para analisar a relação entre o tempo decorrido a partir dos sintomas até o diagnóstico e tratamento no estadiamento e sobrevida. Foram realizadas análises estatísticas descritiva, de tendência linear e de sobrevida pelo método de Kaplan-Meier, com valores de p < 0,05 para significância.

Resultados Os casos estudados de acordo com a histologia foram 1.068 (89,7%) carcinomas (77,2% endometrioides e 22,8% não endometrioides) e 122 (10,3%) sarcomas, com tendência crescente no período (p < 0,05). Histologias de carcinomas não endometrioides, G3 endometrioides e carcinossarcomas consistiram em 30% dos casos. Carcinomas não endometrioides e sarcomas foram mais frequentemente diagnosticados em pacientes acima de 70 anos de idade e em estágio IV (p < 0,05). O subgrupo com 185 mulheres com carcinoma endometrioide apresentou 92% de sangramento uterino anormal e 43% de diagnóstico após curetagem. O tempo médio decorrido entre os sintomas e o diagnóstico foi de 244 dias e entre os sintomas e o tratamento, 376 dias, todos sem associação com estadiamento (p = 0,976) e sobrevida (p = 0,160). Apenas 12% das pacientes iniciaram o tratamento em até 60 dias após o diagnóstico.

Conclusão O número de casos de carcinomas e sarcomas uterinos aumentaram no período de 2001 a 2016. A histologia agressiva compreendeu 30% dos pacientes e, no caso dos carcinomas endometrioides, o tempo decorrido entre os sintomas e o diagnóstico ou tratamento foi longo, embora sem associação com estadiamento ou sobrevida.

Keywords

endometrial neoplasms - uterine sarcomas - epidemiology - neoplasm staging - survival analysis

Palavras-chave

neoplasias endometriais - sarcomas uterinos - epidemiologia - estadiamento de neoplasia - análise de sobrevivência

Contributions

Each author has participated actively and sufficiently in this work and all had final approval of the manuscript version being submitted. E. C. contributed to conception and design, data collection, interpretation of data, and writing of the article; N. V. J. contributed to conception, data collection, and writing of the article; M. M. contributed to data collection and writing of the article; M. T. contributed to interpretation of data and writing of the article; D. Y. contributed to conception and design, interpretation of data, and critical review of the article; and J. T. contributed to conception and design, data collection and analysis, interpretation of data, and writing of the article.




Publication History

Received: 27 April 2020

Accepted: 03 August 2020

Article published online:
19 January 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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