Epidemiology and management of endometrial cancer: experience of International University Hospital Cheikh Khalifa and Mohammed VI Center for cancer treatment at University Hospital Ibn Rochd Casablanca, Morocco

Abstract Background Endometrial cancer is the fourth most common cancer in women in high-income countries and its incidence has increased over the past 20 to 30 years. In Morocco, the incidence is close to those found in developing countries, but it is lower than those found in Western countries. To determine some epidemiological aspects of endometrial cancer in Morocco, we conducted a prospective study over 43 months at the International University Hospital Cheikh Khalifa and the Mohammed VI Center for Cancer Treatment at the Ibn Rochd Casablanca University Hospital, Morocco. 93 cases of endometrial cancer were included. Results The average age was 64. 36.5% of our patients had early menarche. 17.2% had menstrual cycle abnormalities. The nulliparous patients represent 40.8℅. 3 patients in our series underwent medical hormone treatment. 46.2% of patients claimed to have taken oral contraception during their period of genital activity, 79.5℅ were obese, 62.3% of the patients are diabetic and 49.4% are known to be hypertensive. 9.6% of patients are on hormone therapy with Tamoxifen. Metrorrhagia is the first symptom encountered in 62.2% of cases. Ultrasound was performed on all of our first-line patients and pelvic MRI was the most relevant examination in the pre-therapeutic assessment of endometrial cancer. Endometrial adenocarcinoma of the endometriotic type (81.72%) was the most prominent histological type. The therapeutic attitudes practiced were: Extended total colpohysterectomy for 17 patients. Total hysterectomy with bilateral salpingo-oophorectomy for 93 patients. Omentectomy was performed for 11 patients. 78 patients had undergone pelvic lymph node dissection, while 51 patients had undergone an associated lumbarortic dissection. 44.08℅ of cases were diagnosed at stage (IA) and 18.27℅ of cases at stage (III). At the time when we stopped our study, 42 patients had received radiotherapy as adjuvant treatment, ie 45.1% of cases. Conclusions Local and locoregional epidemiological studies should be multiplied to shed light on the interest of prevention by promoting a healthy lifestyle. Besides, genetic studies must be conducted to better understand the place of racial factors as risk factors for this cancer.