TY - JOUR
T1 - Cancers of the corpus uteri treated in South Australian public hospitals
T2 - Trends in clinical management and survival across three decades
AU - Roder, David
AU - Selva-Nayagam, Sudarsha
AU - Paramasivam, Sellvakumaran
AU - Keefe, Dorothy
AU - Olver, Ian
AU - Miller, Caroline
AU - Buckley, Elizabeth
AU - Powell, Kate
AU - Fusco, Kellie
AU - Buranyi-Trevarton, Dianne
AU - Oehler, Martin
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
KW - cancer
KW - chemotherapy
KW - management
KW - radiotherapy
KW - staging
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85087635744&partnerID=8YFLogxK
U2 - 10.1111/ecc.13281
DO - 10.1111/ecc.13281
M3 - Article
C2 - 32639088
AN - SCOPUS:85087635744
SN - 0961-5423
VL - 29
JO - European Journal of Cancer Care
JF - European Journal of Cancer Care
IS - 5
M1 - e13281
ER -