Complications After the Treatment of Endometrial Cancer: A Prospective Study Using the French-Italian Glossary

Piovano, Elisa MD*; Fuso, Luca MD; Poma, Cinzia Baima MD; Ferrero, Annamaria MD, PhD; Perotto, Stefania MD; Tripodi, Elisa MD; Volpi, Eugenio MD; Zanfagnin, Valentina MD; Zola, Paolo MD

International Journal of Gynecological Cancer: March 2014 - Volume 24 - Issue 3 - p 418–426
doi: 10.1097/IGC.0000000000000094
Review Articles

Introduction: The evaluation of treatment complications is crucial in modern oncology because they heavily influence the every day life of patients. Several authors confirmed the reproducibility of the French-Italian glossary to score the complications in patients with endometrial cancer after radiotherapy (RT), but the treatment of endometrial carcinoma is primarily surgical and chemotherapy is often used for high-risk disease.

Objectives: This study aimed to analyze the incidence of complications in our patients treated for endometrial cancer and to verify whether the glossary is a suitable instrument in the description of complications after surgery, RT, and chemotherapy.

Methods: The data of patients affected by endometrial cancer treated in the Gynecology and Obstetrics Academic Department, Azienda Ospedaliera Mauriziano Umberto I in Turin from 2000 to 2009 (with surgery alone or integrated treatments) were prospectively collected, and complications were described using the glossary. Every patient included in the analyses had a minimum of 18 months follow-up.

Results: Of the 271 patients, 68 (25%) experienced at least 1 complication with 87 overall complications. Most of the complications were mild (63%) and were found in the urinary (30%) or cutaneous systems (30%). Forty-four (50%) complications appeared within 1 year after treatment, but 9 (10%) complications appeared after 60 months of follow-up. Patients who were submitted to both surgery and RT showed a trend of higher rate of at least 1 complication (19/58 [32.7%]) if compared with surgery alone (36/135 [26.6%]), even if the difference was not statistically significant (P = 0.09). The incidence of complications in patients treated or not with lymphadenectomy was not statistically different (P = 0.088), whereas patients treated with laparotomy had a higher rate of cutaneous complications if compared with the laparoscopic approach (P = 0.018). The glossary included all observed complications.

Conclusions: One every 4 women treated for endometrial cancer develops a complication. Clinicians should check for complications especially after integrated treatments maintaining surveillance even in the long term. The glossary is a comprehensive instrument to describe the complications of endometrial cancer, regardless of the type of treatment delivered.

*Department of Surgical Sciences, University of Turin, Turin, Italy; †Gynecology and Obstetrics Academic Department, Azienda Ospedaliera Mauriziano Umberto I, Turin, Italy; ‡Gynecology and Obstetrics Department, Azienda Sanitaria Ospedaliera S. Croce e Carle, Cuneo, Italy; and §SSVD Gynecological Oncology, PO S. Anna, Cittá della Salute e della Scienza di Torino, Turin, Italy.

Address correspondence and reprint requests to Elisa Piovano, MD, Department of Surgical Sciences, University of Turin, Corso Dogliotti, 14 - 10126 Turin, Italy. E-mail: piovano.elisa@gmail.com.

The authors declare no conflicts of interest

Received November 16, 2013

Accepted December 19, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.