Real world outcomes of patients with endometrial cancer from a South African radiation oncology unit

Abstract

Background: Endometrial cancer adds significantly to the burden placed on the South African health care system with GLOBOCON 2020 cancer statistics ranking it as the 5th most frequently diagnosed cancer in South African women.

Aim: A retrospective audit to assess real-world clinical outcomes in women with endometrial carcinoma that received radiation as a treatment modality.

Setting: A radiation oncology unit at a public tertiary hospital in the Johannesburg area, Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa.

Methods: Medical records between 2010 and 2020 were evaluated for patients who received either combination external beam (EBRT) and vaginal brachytherapy (VBT) or VBT alone. Overall survival rates (OS) and progression-free survival (PFS) were assessed.

Results: One hundred and two patients were analysed. Demographic profiles were 76,5% black people, 18.6% white people, 3.9% asian people and 1% mixed race. Median age was 66 years (range: 64 years—67 years).Type 1 histology in 70%.OS at 5-year was 61.75% and at 10-year was 40% with stage and histological type being significant contributors. Statisical significance in survival occurred with a combination of LVSI with greater than 50 % myometrial invasion(P=0.038) and a combination of greater than 50% myometrial invasion with positive margins (P=0.032).Radiation treatment was completed in 102 (100%) of the patients.

Conclusion: Real world outcomes of overall survival rates of endometrial carcinoma are lower than projected in our developing country, although contributory high risk factors play a role in keeping with international literature and historic landmark trials.

Contribution: This study contributes to the growing body of research on endometrial cancer outcomes in low- and middle-income countries (LMICs).