Endometrial cancer in young women. A retrospective matched cohort study.
| dc.contributor.advisor | Botha, Matthys Hendrik | en_ZA |
| dc.contributor.author | Dowlut, Tariq Hussein | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology. | en_ZA |
| dc.date.accessioned | 2021-12-06T09:55:48Z | |
| dc.date.accessioned | 2021-12-22T14:29:38Z | |
| dc.date.available | 2021-12-06T09:55:48Z | |
| dc.date.available | 2021-12-22T14:29:38Z | |
| dc.date.issued | 2021-12 | |
| dc.description | Thesis (MMed)--Stellenbosch University, 2021. | en_ZA |
| dc.description.abstract | ENGLISH ABSTRACT: OBJECTIVE: Endometrial cancer is the second most common gynaecological cancer in South Africa. It typically arises in the sixth and seventh decades of life. However, an increasing number of premenopausal women are being diagnosed with endometrial cancer. Delay in diagnosis in younger women is due to symptoms being ascribed to abnormal uterine bleeding. The objective of this study was to carry a review of the clinical, pathological and management of endometrial cancers in younger women to identify risk factors, characterise histology and appraisal of treatment received. METHODS: We did a retrospective matched study of a cohort of women aged 55 years or younger with histologically confirmed endometrial carcinoma. Each case was matched to two randomly selected control cases of histologically proven endometrial cancer patients aged more than 55 years old. It was conducted at Tygerberg Hospital, the largest tertiary hospital in the Western Cape Province of South Africa. We examined patient folders from the Department of Gynaecologic Oncology from 2014 – 2018. Clinical characteristics including age, parity, hypertension, diabetes mellitus, hormone therapy, tamoxifen use, personal history of cancer and family history of cancer were obtained. Outcomes including histological type and grade, myometrial depth invasion, lympho‐vascular space invasion, lymph node involvement, extrauterine spread, stage, treatment plan and need for adjuvant therapy were reviewed. RESULTS: 15 patients 55 years of age or less were identified (range 40‐55, median 52). Only 20% were nulliparous. All the patients had at least class 2 obesity with 50% having class 3 obesity. The incidence of hypertension and diabetes were 66.7% and 56.7% respectively. Only 2 patients had a history of tamoxifen use for breast cancer. 33.3% had a personal history of a cancer and 26.7% reported having a first degree‐ relative with cancer. All the 15 patients (100%) in the younger cohort had Type I (endometrioid adenocarcinoma) compared to 50% in more than 55‐year‐old group. Statistical significance differences were found for histological grade (p‐value 0.004), myometrial depth invasion (p‐value 0.02), extrauterine spread other than lymph node (p‐value 0.006) and need for adjuvant therapy (p‐value 0.007). No significant differences were found for lympho‐vascular space invasion (p‐value 0.18), lymph node spread (p‐value 0.95) and stage (p‐value 0.107). Despite no statistical significance was found for overall disease stage between the two groups, 11 patients (73.4%) presented with stage I disease in the younger cohort. None of the patients received conservative management and were surgically staged by open laparotomy. CONCLUSION: Obesity is a significant risk factor in our population. Oestrogen excess seems to be the main aetiology of endometrial cancer in the local population. Younger patients typically present with Type I endometrioid adenocarcinoma, low grade and less myometrial invasion. There is less need for adjuvant radiotherapy in this group of patients. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar | af_ZA |
| dc.description.version | Masters | en_ZA |
| dc.format.extent | 42 pages | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/123928 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Endometrium -- Cancer | en_ZA |
| dc.subject | Gynecologic cancer | en_ZA |
| dc.subject | UCTD | en_ZA |
| dc.subject | Gynecology -- Diagnosis | en_ZA |
| dc.title | Endometrial cancer in young women. A retrospective matched cohort study. | en_ZA |
| dc.type | Thesis | en_ZA |