Real-world outcomes in patients with advanced endometrial cancer: A retrospective cohort study of US electronic health records.
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ICR Author
Author
Monk, BJ
Smith, G
Lima, J
Long, GH
Alam, N
Nakamura, H
Meulendijks, D
Ghiorghiu, D
Banerjee, S
Type
Journal Article
Metadata
Show full item recordAbstract
<h4>Objectives</h4>To characterize clinical outcomes of women with advanced/recurrent endometrial cancer (AEC) in routine practice using electronic health records from a real-world database.<h4>Methods</h4>Adult women diagnosed with AEC (stage III/IV, or early stage with locoregional/distant recurrence) between January 1, 2013 and September 30, 2020, inclusive, were eligible provided they received platinum-based chemotherapy at any time following diagnosis and had ≥2 clinical visits. Follow-up was from initiation of systemic treatment after advanced diagnosis (index) until March 30, 2021, last available follow-up, or death, whichever occurred first. Outcomes, by histological subtype, included Kaplan-Meier estimates of overall survival (OS) and time to first subsequent therapy or death (TFST).<h4>Results</h4>Of the 2202 women with AEC, most were treated in a community setting (82.7%) and presented with stage III/IV disease at initial diagnosis (74.0%). The proportion with endometrioid carcinoma, uterine serous carcinoma (USC), and other AEC subtypes was 59.8%, 25.0%, and 15.2%, respectively. The most common first systemic treatment following advanced/recurrent diagnosis was platinum-based combination chemotherapy (82.0%). Median OS (95% CI) from initiation of first systemic treatment was shorter with USC (31.3 [27.7-34.3] months) and other AECs (29.4 [21.4-43.9] months) versus endometrioid carcinoma (70.8 [60.5-83.2] months). Similar results were observed for TFST. Black/African American women had worse OS and TFST than white women.<h4>Conclusions</h4>Women with AEC had poor survival outcomes, demonstrating the requirement for more effective therapies. To our knowledge, this is the most comprehensive evaluation of contemporary treatment of AEC delivered in a community setting to date.
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Subject
Humans
Carcinoma, Endometrioid
Neoplasms, Cystic, Mucinous, and Serous
Endometrial Neoplasms
Neoplasm Recurrence, Local
Antineoplastic Combined Chemotherapy Protocols
Neoplasm Staging
Hysterectomy
Survival Rate
Retrospective Studies
Cohort Studies
Aged
Middle Aged
African Americans
United States
Female
Electronic Health Records
Kaplan-Meier Estimate
Antineoplastic Agents, Immunological
Whites
Language
eng
Date accepted
2021-12-04
Citation
Gynecologic oncology, 2022, 164 (2), pp. 325 - 332