Clinicopathological Characteristics, Management and Outcomes of Endometrial Cancer at Kenyatta National Hospital, 2014 -2022

Abstract

Introduction Endometrial cancer typically affects postmenopausal women presenting initially with irregular vaginal bleeding, and lower abdominal pain. With a demonstrated overall survival (OS) of 88% for endometriod endometrial cancer histology sub-type at 5 years (Åkesson, Adok, & Dahm- Kähler, 2023), surgery is the main treatment modality. However, patients with recurrence tend to have a drop in OS to less than 50%. Known risk factors for type 1 endometrial cancers are mainly obesity, hyper estrogenic conditions, and hyperlipidemia. Objective This study evaluated the clinicopathological characteristics, management, and outcomes of patients with cancer of the endometrium at Kenyatta National Hospital between 1st January 2014-31st December 2022. Methodology We conducted a retrospective study of patients with endometrial cancer followed up at the KNHGOPC (Gynecological outpatient Clinic) between 2014 to 2022. We abstracted data for 131 files selected through convenient sampling. Data collection: Descriptive variables included age at diagnosis, surgical treatment provided and outcomes. Outcome variables included complete response, partial response, stable or progressive disease and recurrence. Independent variables were FIGO stage and histological grade. Surgical management included bilateral salpingo-oophorectomy and hysterectomy, with/without infracolic Omentectomy, para-aortic and pelvic lymph node dissection. Data analysis: Descriptive statistics, continuous variables such as age were presented as means (standard deviation) or median (interquartile range), while categorical variables were described using frequencies and proportions. Inferential statistics to ascertain likelihood of association with the various outcomes were done using logistic regression model.