Cancers of the corpus uteri treated in South Australian public hospitals: Trends in clinical management and survival across three decades

David Roder, Sudarsha Selva-Nayagam, Sellvakumaran Paramasivam, Dorothy Keefe, Ian Olver, Caroline Miller, Elizabeth Buckley, Kate Powell, Kellie Fusco, Dianne Buranyi-Trevarton, Martin Oehler

Research output: Contribution to journalArticle

Abstract

Objective: To investigate treatment and survival over three decades. Methods: Clinical registry data from three major public hospitals analysed using Kaplan–Meier product-limit estimates and multivariate proportional hazard regression to determine disease-specific survival. Results: Five-year survival increased from 75% to 84%. The adjusted hazard ratio (HR, 95% CI) was 0.56 (0.41, 0.77) for 2010–2016 compared with 1984–1989 and was higher for: ages 80+ years; more advanced stages; poorly differentiated tumours; and complex mixed epithelial and mesenchymal tumours and sarcomas. Treatment was by surgery (92%), radiotherapy (33%), chemotherapy (12%) and hormone therapy (10%). Adjusted analyses showed radiotherapy and hormone therapy were less common from 1990 and chemotherapy more common for 2010–2016. Treatment likelihood was lower for ages ≥80 years, mixed epithelial and mesenchymal tumours receiving surgery and chemotherapy, but higher for radiotherapy. Advanced cancers (FIGO stage IV) had less surgery but more non-surgical treatments. Marginal evidence presented of more hormone therapy for high socio-economic areas. Conclusions: Survival was equivalent to national figures for Australia and the United States, but potentially higher than for England and Wales. Cases aged 80+ years had less care and poorer survival. Findings illustrate the complementary roles of hospital and population-based registries in local service evaluation.

Original languageEnglish
Article numbere13281
JournalEuropean Journal of Cancer Care
Volume29
Issue number5
DOIs
Publication statusAccepted/In press - 8 Jul 2020

Keywords

  • cancer
  • chemotherapy
  • management
  • radiotherapy
  • staging
  • surgery

ASJC Scopus subject areas

  • Oncology

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