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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:

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.