{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:40:49Z","timestamp":1760236849220,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u010cesk\u00e1 Rozvojov\u00e1 Agentura","award":["NU21-09-00031"],"award-info":[{"award-number":["NU21-09-00031"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Endometrial cancer is the most common gynecological malignancy in developed countries with no screening available. There is still a tendency to provide invasive bioptic verification in asymptomatic women with abnormal ultrasound findings to diagnose carcinoma in a preclinical phase; even though, it is not supported by European guidelines. Our goal was to determine DFS (disease-free survival), OS (overall survival), and DSS (disease-specific survival) differences between symptom-free and symptomatic (bleeding, or spotting) endometrial cancer patients with similar stage and tumor\/clinical characteristics. Methods: All of our patients with endometrial cancer following surgical treatment between 2006 and 2019 were assessed, evaluating risk factors for recurrence and death while focusing on bleeding using univariable and multivariable analysis. Results: 625 patients meeting the inclusion criteria were divided into asymptomatic (n = 144, 23%) and symptomatic (n = 481, 77%) groups. The median follow-up was 3.6 years. Using univariable analysis, symptomatic patients had a three times higher risk of recurrence (HR 3.1 (95% Cl 1.24\u20137.77), p = 0.016). OS (HR 1.35 (0.84\u20132.19), p = 0.219) and DSS (HR 1.66 (0.64\u20134.28), p = 0.3) were slightly worse without reaching statistical significance. In our multivariable analysis, symptomatology was deemed completely insignificant in all monitored parameters (DFS: HR 2.03 (0.79\u20135.24), p = 0.144; OS: HR 0.72 (0.43\u20131.21), p = 0.216). Conclusions: The symptomatic endometrial cancer patients risk factor of earlier recurrence and death is insignificantly higher when compared with the asymptomatic cohort. However, multivariable analysis verifies that prognosis worsens with other clinically relevant parameters, not by symptomatology itself. In terms of survival outcome in EC patients, we recognized symptomatology as a non-significant marker for the patient\u2019s prognosis.<\/jats:p>","DOI":"10.3390\/cancers14010115","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:18:15Z","timestamp":1640654295000},"page":"115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Does an Endometrial Cancer Diagnosis among Asymptomatic Patients Improve Prognosis?"],"prefix":"10.3390","volume":"14","author":[{"given":"Petra","family":"Vinklerov\u00e1","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Ovesn\u00e1","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark\u00e9ta","family":"Bedna\u0159\u00edkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lubo\u0161","family":"Min\u00e1\u0159","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3826-5675","authenticated-orcid":false,"given":"Michal","family":"Felsinger","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jitka","family":"Hausnerov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4858-1951","authenticated-orcid":false,"given":"V\u00edt","family":"Weinberger","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, University Hospital Brno and Faculty of Medicine, Masaryk University, 60200 Brno, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. 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