144 Experience with advanced endometrial cancer at a single tertiary care oncology centre: a 10-year retrospective audit

Introduction/Background This single centre study aims to assess clinical behaviour, treatment patterns and clinical outcomes of patients with advanced endometrial cancer (AEC). Methodology This retrospective study assessed patients who reported to Amrita Institute of Medical Sciences, Kochi in the 10-year period from January 2011-December 2020.Patients with AEC (Stage IIIB - IVB according to FIGO 2009), any histology, having at least 2 documented visits and having received at least one cycle of chemotherapy were included. Demographic,pathological and clinical parameters were calculated in terms of mean, median and percentages.Overall survival (OS) was analyzed using Kaplan-Meier curve. Results Eighty-two patients met the inclusion criteria. Majority of patients presented with stage IVB disease (46.3%).Endometroid histology was seen in 41.5% while serous and other subtypes were found in 39% and 19.5% respectively. Primary debulking surgery (PDS) was done in 59.8% cases while 40.2% cases received neo-adjuvant chemotherapy (NACT).Ten percent patients had sub-optimal resection in PDS group versus 0% in NACT+ Interval debulking surgery (IDS). Median follow up duration of the cohort was 48 months.The median OS was 48 months in endometroid subtype, 39 months in serous and 33 months in other histologies. Median OS in patients with ER/PR positive and p53 positive disease were 44 months and 38 months respectively. Overall, 25.6% patients had recurrences and 20% patients had disease progression.Patients with sub-optimal resection had disease progression in 60% cases. Second line treatment was given to 35.3% patients with most common being combined platinum agents.Other drugs used in second line and beyond included non-platinum, hormonal or targeted therapy agents. Conclusion Patients with endometroid endometrial cancer have a better prognosis as compared to serous carcinoma and other histologies.Patients with endocrine receptor positive disease performed better than p53 positive disease.Patients with stage IVB disease respond to NACT allowing an interval optimal debulking. Sub-optimal resection leads to poorer outcomes. Disclosures None.