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Trends in incidence and hormonal management of endometrial cancer during potentially reproductive age in Japan: a population-based study

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Abstract

Background

We aimed to investigate the trends in the incidence and treatment of endometrial cancer (EC) during potentially reproductive age in Japan, with a special focus on the relative oncologic safety of hormonal therapy (HT) over surgery.

Methods

This population-based retrospective cohort study was conducted using data from the Osaka Cancer Registry from 2004 to 2018. Women with EC were first identified and then distributions of age, stage, histology, and initial treatment were examined. Then, the relative oncologic safety of HT over surgery in patients under the age of 50 years was evaluated.

Results

Among the 9417 patients with EC, 1937 were diagnosed during their potentially reproductive age (< 50 years). The incidence of EC during potentially reproductive age has increased from 18.5% in 2004–2011 to 21.9% in 2012–2018. ECs during potentially reproductive age more frequently displayed favorable characteristics, such as endometrioid histology, and lower histological grade than those in non-potentially reproductive age. Among the 1223 patients diagnosed with localized endometrioid EC, 74 cases (6.0%) received HT as an initial treatment, while 1100 cases (90.0%) underwent surgery as their initial treatment. When the two treatment groups were compared, there was no significant difference in overall survival (p = 0.3713). The estimated 5-year survival rates were 100 and 98.8% in the HT and surgery groups, respectively.

Conclusion

EC is increasingly diagnosed during potentially reproductive age in Japan. The use of HT as an initial treatment is increasing, and achieved comparable survival outcomes to urgery against localized endometrioid EC during the potentially reproductive age.

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Data availability statement

The data supporting this study's findings are available from the corresponding author upon reasonable request.

References

  1. Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209–249

    Article  PubMed  Google Scholar 

  2. https://ganjoho.jp/reg_stat/statistics/data/dl/index.html#a14. Accessed 26 Nov 2023

  3. Yaegashi N (2020) Gynecologic cancer committee report in 2018. Acta Obstet Gynaecol Jpn 72:800–856

    Google Scholar 

  4. Kato K, Terauchi M (2021) Annual report of the Women’s Health Care Committee, Japan Society of Obstetrics and Gynecology, 2020. J Obstet Gynaecol Res 47:52–62

    Article  PubMed  Google Scholar 

  5. Yamagami W, Mikami M, Nagase S et al (2020) Japan society of gynecologic oncology 2018 guidelines for treatment of uterine body neoplasms. J Gynecol Oncol 31:e18

    Article  PubMed  Google Scholar 

  6. Abu-Rustum N, Yashar C, Arend R et al (2023) Uterine neoplasms, version 1.2023, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 21:181–209

    Article  CAS  PubMed  Google Scholar 

  7. https://www.mhlw.go.jp/toukei/saikin/hw/jinkou/tokusyu/syussyo07/index.html. Accessed 26 Nov 2023

  8. Uccella S, Zorzato PC, Dababou S et al (2022) Conservative management of atypical endometrial hyperplasia and early endometrial cancer in childbearing age women. Medicina (Kaunas) 58:1256

    Article  PubMed  Google Scholar 

  9. Rodolakis A, Biliatis I, Morice P et al (2015) European society of gynecological oncology task force for fertility preservation: clinical recommendations for fertility-sparing management in young endometrial cancer patients. Int J Gynecol Cancer 25:1258–1265

    Article  PubMed  Google Scholar 

  10. Gunderson CC, Fader AN, Carson KA et al (2012) Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma: a systematic review. Gynecol Oncol 125:477–482

    Article  CAS  PubMed  Google Scholar 

  11. Zhao XL, Du ZQ, Zhang X et al (2021) Fertility-preserving treatment in patients with early-stage endometrial cancer: a protocol for systematic review and meta-analysis. Medicine (Baltimore) 100:e27961

    Article  CAS  PubMed  Google Scholar 

  12. Greenwald ZR, Huang LN, Wissing MD et al (2017) Does hormonal therapy for fertility preservation affect the survival of young women with early-stage endometrial cancer? Cancer 123:1545–1554

    Article  CAS  PubMed  Google Scholar 

  13. Ohyagi-Hara C, Sawada K, Aki I et al (2015) Efficacies and pregnant outcomes of fertility-sparing treatment with medroxyprogesterone acetate for endometrioid adenocarcinoma and complex atypical hyperplasia: our experience and a review of the literature. Arch Gynecol Obstet 291:151

    Article  CAS  PubMed  Google Scholar 

  14. https://oici.jp/ocr/history/basis.html. Accessed 26 Nov 2023

  15. Mabuchi S, Sasano T, Komura N et al (2023) Comparison of the survival outcomes of minimally invasive surgery with open surgery in patients with uterine-confined and node-negative cervical cancer: a population-based study. Cancers (Basel) 15:2756

    Article  PubMed  Google Scholar 

  16. Sasano T, Mabuchi S, Komura N et al (2023) Evaluation of survival outcomes between minimally invasive and open surgery in the treatment of early-stage endometrial cancer: a population-based study in Osaka Japan. Jpn J Clin Oncol 53:791–797

    Article  PubMed  Google Scholar 

  17. Ramirez PT, Frumovitz M, Bodurka DC et al (2004) Hormonal therapy for the management of grade 1 endometrial adenocarcinoma: a literature review. Gynecol Oncol 95:133–138

    Article  CAS  PubMed  Google Scholar 

  18. Qin Y, Yu Z, Yang J et al (2016) Oral progestin treatment for early-stage endometrial cancer: a systematic review and meta-analysis. Int J Gynecol Cancer 26:1081–1091

    Article  PubMed  Google Scholar 

  19. Chae-Kim J, Garg G, Gavrilova-Jordan L et al (2021) Outcomes of women treated with progestin and metformin for atypical endometrial hyperplasia and early endometrial cancer: a systematic review and meta-analysis. Int J Gynecol Cancer 31:1499–1505

    Article  PubMed  Google Scholar 

  20. Pashov AI, Tskhay VB, Ionouchene SV (2012) The combined GnRH-agonist and intrauterine levonorgestrel-releasing system treatment of complicated atypical hyperplasia and endometrial cancer: a pilot study. Gynecol Endocrinol 28:559–561

    Article  CAS  PubMed  Google Scholar 

  21. Kahramanoglu I (2021) Hysteroscopic treatments for endometrial malignancies and premalignancies: state of the art. Minim Invasive Ther Allied Technol 30:272–277

    Article  PubMed  Google Scholar 

  22. https://clinicaltrials.gov/study/NCT05538897. https://clinicaltrials.gov/study/NCT05154487. Accessed 26 Nov 2023

  23. Slomovitz BM, Filiaci VL, Walker JL et al (2022) A randomized phase II trial of everolimus and letrozole or hormonal therapy in women with advanced, persistent or recurrent endometrial carcinoma: a GOG Foundation study. Gynecol Oncol 164:481–491

    Article  CAS  PubMed  Google Scholar 

  24. Heudel P, Frenel JS, Dalban C et al (2022) Safety and efficacy of the mTOR Inhibitor, vistusertib, combined with anastrozole in patients with hormone receptor-positive recurrent or metastatic endometrial cancer: the VICTORIA multicenter, open-label, phase 1/2 randomized clinical rrial. JAMA Oncol 8:1001–1009

    Article  PubMed  PubMed Central  Google Scholar 

  25. Konstantinopoulos PA, Lee EK, Xiong N et al (2023) A phase II, two-stage study of letrozole and abemaciclib in estrogen receptor-positive recurrent endometrial cancer. J Clin Oncol 41:599–608

    Article  CAS  PubMed  Google Scholar 

  26. Mirza MR, Bjørge L, Marmé F et al (2020) A randomised double-blind placebo-controlled phase II trial of palbociclib combined with letrozole (L) in patients (pts) with oestrogen receptor-positive (ER+) advanced/recurrent endometrial cancer (EC): NSGO-PALEO/ENGOT-EN3 trial. Ann Oncol 31:S1160

    Article  Google Scholar 

  27. Cancer Genome Atlas Research Network, Kandoth C, Schultz N et al (2013) Integrated genomic characterization of endometrial carcinoma. Nature. 497:67–73

    Article  Google Scholar 

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Acknowledgements

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Author notes

  1. Tomoyuki Sasano and Seiji Mabuchi have contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Osaka Saiseikai Nakatsu Hospital, Osaka, 530-0012, Japan

    Tomoyuki Sasano

  2. Department of Gynecology, Osaka International Cancer Institute, 3-1-69, Otemae, Osaka, 541-8567, Japan

    Seiji Mabuchi, Mina Sakata & Shoji Kamiura

  3. Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, 597-0015, Japan

    Naoko Komura

  4. Cancer Control Center, Osaka International Cancer Institute., Osaka, 541-8567, Japan

    Toshitaka Morishima & Isao Miyashiro

Authors
  1. Tomoyuki Sasano
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  2. Seiji Mabuchi
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  3. Naoko Komura
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  4. Mina Sakata
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  5. Shoji Kamiura
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  6. Toshitaka Morishima
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  7. Isao Miyashiro
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Contributions

Conceptualization, S.M.; Methodology, S.M., and T.S.; Formal analysis, T.S.; Investigation, T.S. and S.M.; Data curation, T.S. and. N.K.; Writing-original draft preparation, S.M. and T.S.; Writing—review and editing, M.S, and S.K.; Supervision, T.M. and I.M.

Corresponding author

Correspondence to Seiji Mabuchi.

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Conflicts of interest

The authors declare no conflicts of interest.

Ethical approval

The study protocol was reviewed and approved by the Research Ethics Committee of Osaka International Cancer Institute (no. 21143-2)

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Not applicable.

Institutional review board statement

The study was reviewed and approved by the Research Ethics Committee of Osaka International Cancer Institute (no. 21143-2).

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Sasano, T., Mabuchi, S., Komura, N. et al. Trends in incidence and hormonal management of endometrial cancer during potentially reproductive age in Japan: a population-based study. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02511-5

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  • DOI: https://doi.org/10.1007/s10147-024-02511-5

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