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Endometrial cancer after the Manchester procedure: a nationwide cohort study

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Abstract

Introduction and hypothesis

We aimed to investigate whether the Manchester procedure affects the risk and prognosis of endometrial cancer.

Methods

All Danish residents have a personal number permitting linkage of nationwide registers on the individual level enabling epidemiological studies with lifelong follow-up. We performed a nationwide historical cohort study including Danish women born before 2000 undergoing the Manchester procedure (N = 23,935) during 1977–2018. We included women undergoing anterior colporrhaphy as a reference group (N = 51,008) because of comparable inclination to consult a doctor and clinical similarities. Main outcomes were the number of women diagnosed with endometrial cancer, the stage of endometrial cancer at time of diagnosis, and cancer-specific and overall mortality. We followed the cohort until endometrial cancer/death/emigration/hysterectomy/31 December 2018. We performed chi-square test for trend to compare the diagnostic stage and Cox regressions to analyze the risk of endometrial cancer and mortality. The models were adjusted for age, calendar year, income level, and parity.

Results

During follow-up (median 13 years), 271 (1.13%) women were diagnosed with endometrial cancer after the Manchester procedure and 520 (1.05%) after anterior colporrhaphy. The adjusted hazard ratio (HR) for endometrial cancer was 1.00 [95% confidence interval (CI) 0.86–1.16]. No difference in stage of cancer was found (p = 0.18) nor when stratifying for calendar year. The HR for cancer-specific mortality and overall mortality after the Manchester procedure was 0.87 (95% CI 0.65–1.16) and 0.93 (95% CI 0.77–1.12), respectively.

Conclusions

The Manchester procedure does not affect the risk or prognosis of endometrial cancer.

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Funding

The study was funded by The research council at Herlev Gentofte Hospital, Helsefonden, and The Department of Obstetrics and Gynecology, Herlev Gentofte Hospital. The funding sources had no role in the design, conduct, analysis or reporting of the study.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Herlev and Gentofte University Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark

    Karen R. Husby & Niels Klarskov

  2. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Karen R. Husby & Niels Klarskov

  3. Center for Clinical Epidemiology, Odense University Hospital, DK-5000, Odense, Denmark

    Kim O. Gradel

  4. Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark

    Kim O. Gradel

Authors
  1. Karen R. Husby
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  2. Kim O. Gradel
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Contributions

KR Husby: Project development, Data management, Analysis and interpretation of data, Manuscript writing

KO Gradel: Data management, Analysis and interpretation of data, Manuscript editing

N Klarskov: Project development, Interpretation of data, Manuscript editing

All authors have approved the final version submitted for publication and are responsible for the entire work.

The study was presented at the virtual 46th International Urogynecological Association (IUGA) Annual Meeting, December 2021.

Corresponding author

Correspondence to Karen R. Husby.

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Husby, K.R., Gradel, K.O. & Klarskov, N. Endometrial cancer after the Manchester procedure: a nationwide cohort study. Int Urogynecol J 33, 1881–1888 (2022). https://doi.org/10.1007/s00192-022-05196-4

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  • DOI: https://doi.org/10.1007/s00192-022-05196-4

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