Endometrial cancer is the second most frequent gynecological cancer after breast cancer [1] . It affects about 4.4% of women globally, with an estimated 382,100 new cases in 2018 [2] . In France, it causes about 1200 deaths per year, with about 6500 new cases annually [3] . It represents about 8% of cancers in women and is the fifth most common cancer after breast, colon-rectum and lung cancers [3] . In Canada, endometrial cancer’s incidence and mortality rate were 35.7 and 5.3 per 100,000 women respectively, in 2017 [4] . In Cameroon, it ranked third among gynecological cancers in 2015, with 176 cases and a frequency of 6.88%, mainly in postmenopausal women [5] . In Burkina Faso, it accounted for 0.87% of all cancers and 2.7% of gynaecological and breast cancers in 2011 [6] .

This disease’s high frequency and mortality and the lack of recent data on its characteristics in our department prompted us to conduct this study. The aim of the study was to describe the epidemiological, histological and therapeutic aspects of endometrial cancer in our department.

Among the 2793 files of gynecological pathologies identified in the department during the study period, we recorded 86 cases of endometrial cancer, representing a frequency of 3.1% (Figure 1).

Endometrial cancer is the third most common gynaecological cancer in our department after cervical cancer and breast cancer, with a frequency of 3.1%. This frequency is lower than that reported by Engbang et al. [5] in Cameroon, who found that endometrial cancer represented 6.88% of gynaecological cancers. However, it is higher than those reported by Ouédraogo et al. [6] in Burkina- Faso and Dem et al. [7] in Dakar, which were 2.7% and 2.0% of gynaecological and breast cancers, respectively. Several authors have reported that endometrial cancer is the most common gynaecological cancer in developed countries [8] [9] [10] . The frequency of endometrial cancer in our department has changed over time, with a decrease in the number of cases in 2015 and 2020 and a peak in 2021.

The mean age of the patients was 63 years old, ranging from 40 to 86 years old. The mean age found in this study is higher than those reported by Chekman et al. [10] in Algeria, Ouédraogo et al. [6] in Burkina-Faso and Engbang et al. [5] in Cameroon, which was 58.54 years, 56.7 years and 54.43 years respectively. The most affected age group was 60 - 69 years old, with a frequency of 54.7%. Engbang et al. [5] and Ouédraogo et al. [6] found higher frequencies for the age groups of 50 - 59 years and 51 - 60 years, respectively. Most of the patients were postmenopausal (91.9%). This result confirms that endometrial cancer is mainly a pathology of postmenopausal women [11] [12] . The same observation was made by Ouédraogo et al. [6] , who found a proportion of 89.5% of postmenopausal patients in their study. Most of the patients were obese (65.1%), hypertensive (77.1%) and nulliparous (30.2%). According to Sobel et al. [4] , obesity is a risk factor for endometrial cancer, and each increase of 10 units in body mass index increases the relative risk of endometrial cancer by 2.89. Jerome et al. [11] and Lansac [3] also reported that overweight is the first etiological factor due to hyperestrogenism, which is determines by promoting the aromatisation of androgens into estrogens in peripheral fats.

More than half of the patients (53.4%) were diagnosed with stage I of the disease. This result is consistent with those of Chekman et al. [10] and Scattarelli et al. [12] , who reported 62.7% and 46% of patients with stage I endometrial cancer, respectively. Endometrioid adenocarcinoma was the most frequent histological type in our study (68.6%). The same observation was made by Ouédraogo et al. [6] , Engbang et al. [5] and Chekmal et al. [10] , who reported 67.0%, 68.2% and 84.0% of endometrioid adenocarcinoma respectively. Among the non-endometrioid types, serous carcinoma was the most common with 15.1%. Scattarelli et al. [12] , on the other hand, reported higher frequencies of carcinosarcoma and serous or seropapillary carcinoma, with respective frequencies of 45.9% and 39.2%. Surgery was the main treatment performed (96.6%). The surgical procedure performed depended on the stage of the disease, ranging from total hysterectomy plus bilateral adnexectomy for stage I to colpohysterectomy plus adnexectomy and lymph node dissection beyond stage I. This attitude is in accordance with the clinical guidelines of the Canadian Society of Gynecology and Obstetrics that surgery could be limited to hysterectomy and bilateral salpingo-oophorectomy as an acceptable alternative in patients with stage I disease [13] . Leary et al. [14] concluded that total hysterectomy and removal of the adnexa constitute the standard treatment for stage I endometrial cancer. According to Sobel et al. [4] , for stage I, chemotherapy was rarely used, either pre- or post-operatively, in our study. According to Lheureux et al. [15] , adjuvant chemotherapy can give promising results after surgery.

After a mean follow-up of 15 months, 84.5% of operated patients were alive. Chekman et al. [10] reported a 5-year overall survival that could vary from 92% to 42% for stage I depending on the histological characteristics of the tumor. For Jerome et al. [11] , the 5-year survival rate for all stages combined, is estimated at 75%.

Endometrial cancer ranks third among gynaecological cancers in our department. It mainly affects postmenopausal women over 60 who are nulliparous, obese and hypertensive. Endometrioid adenocarcinoma is the most common histological subtype. Most of the patients are diagnosed at stage I. Surgery is the main treatment modality; most patients are alive after a mean follow-up of 15 months. Early detection and management of this disease could improve the prognosis.

The authors declare no conflicts of interest regarding the publication of this paper.

Diallo, A., Balde, O., Sylla, A.M., Conte, I., Soumah, A.F.M. and Keita, N. (2023) Endometrial Cancer: Epidemiological, Histological and Thera- peutic Aspects in the Gynecology-Obstetrics Department of the Donka National Hospital, CHU of Conakry. Open Journal of Obstetrics and Gynecology, 13, 1507-1515. https://doi.org/10.4236/ojog.2023.139126