The endometrial cancer in Southern Tunisia: Investigation about 52 cases

To study the epidemiological, clinical, paraclinical and therapeutic caracteristics of this cancer in south Tunisia population, a retrospective descriptive and analytic study was conducted over a period of 12 years from January 1993 until December 2004 on 52 patients carrying endometrial cancer. Diagnosis and therapeutic management were made in the departments of Obstetrics and Gynecology University Hospital HediChaker of Sfax and radiotherapy at the University Hospital Habib Bourguiba of Sfax. The average age of patients was 57.53 years. Menopause was observed in 76.92% cases. Hypertension, obesity and diabetes were observed, respectively, in 40.38%, 26.92% and 11.53% of cases. The mean delay of consulting was 8 months. Uterine bleeding was observed in 98.07% cases. Endometrial b iopsy curettage or directed biopsy was performed in 50 women (96.15%) including 35 women under hysteroscopy. Histopathological examination was conclusive in 46 patients (92%) Adenocarcinoma was the most frequent histological type found in 39 cases (84.78%). Physical examination under general anesthesia was carried out for 44 patients it was normal in 77.27% of cases. The magnetic resonance imaging was performed in 3 patients. Stage I and II were the most observed stages. Preoperative brachytherapy was achieved only in 30 women. Surgery was indicated in 49 cases (94.23%). Thirty three patients (63.46%) received supplemental external radiotherapy. Overall survival at 5 years was 66.8%. Endometrial cancer in associated with many risk factors it must be evoked in front of any abnormal bleeding in aged women. Endometrial biopsy curettage performed under hysteroscopy allows the diagnosis in most cases. Magnetic resonance imaging allows tumorstaging. Treatment is based on the triade brachytherapy, surgery and external post operative radiotherapy. Chemotherapyis added in the therapeutic arsenal in high recidive risk tumor.