Variations in the management and survival of women with endometrial cancer in south east England

Objectives: To compare the management of women with endometrial cancer to locally developed clinical guidelines, and to examine the factors influencing their survival. Study Design: Observational study in seven districts of the South East Thames Regional Health Authority. Results: 133 women were diagnosed with endometrial cancer. 40 (30%) women had all appropriate staging investigations, stage was stated in the notes for 38 (29%) women, and 42 (32%) women were treated appropriately. Forty-three (32%) women died during the study period. Histology of adenocarcinoma, stage I disease, appropriate surgery/radiotherapy, good differentiation of tumour and depth of myometrial invasion less than two-thirds were significantly associated with increased survival. Conclusions: In addition to the usual clinical variables, appropriate treatment was associated with increased survival. Adherence to the guidelines for both treatment and staging was low, so ways of improving compliance with guidelines need to be found.