An audit of the quality of endometrial cancer care in a specialised unit

Background Endometrial cancer is the 5th most common female cancer in Scotland and though cure rates are good, 25% of women still die of their disease. Staging has been shown to be poorly performed in Scotland-wide audit and inadequate staging is a predictor of worse outcome. Only 12% of women with endometrial cancer in Scotland are operated upon by a specialist gynaecological oncologist.

Aims To determine if the quality of staging information in endometrial cancer is improved in a region where all cases are managed by specialist gynaecological oncologists.

Methods All 108 women diagnosed and treated with endometrial cancer in Grampian in 2002 and 2003 had a retrospective case note assessment of the completeness of staging information. This was compared to previously published Scottish results.

Results Completeness of staging was high. The International Federation of Gynecology and Obstetrics (FIGO) stage was available in 100% of women. Chest X Ray was performed in 85% and peritoneal cytology in 93%. Pelvic lymphadenectomy was performed in 28%. All these results were significantly better than in the Scottish audit.

Conclusion Centralisation of women with endometrial cancer results in accurate staging information. However it is not yet known what effect this may have on outcome.