278 Personalization of the Treatment in Patients with Endometrial Cancer and Life-Threatening Comorbidities

Introduction Endometrial cancer (EC) is the most common oncogynecological malignancy. Currently, there is a trend of the co-existence of EC and somatic comorbidities. Aim To evaluate the single-center experience in treating patients with EC and life-threatening comorbidities, to optimize the management. Methods We analyzed the treatment outcomes in 17 patients with EC and somatic comorbidities, who were admitted to the Almazov National Medical Research Centre from 01.01.2019 to 30.04.2020. In 52.9% of patients, the Charlson Comorbidity Index (CCI) exceeded 6 points, which corresponds to 3 or more diseases with a severe course. The majority of patients had concurrent cardiovascular disorders. Previously, 23.5% of patients had coronary artery stents, 11.8% -mechanic heart valves, while 17.6% experienced a recurrent pulmonary embolism. BMI was above 40 kg/m2 in 23.5% of cases. Results All patients were managed by a multidisciplinary team, including an oncologist, cardiologist, cardio-resuscitator, and other specialists. An interdisciplinary approach allowed us to perform radical surgery, taking into account the tumor process’s characteristics. No intraoperative complications were noted. Postoperatively, one patient (5.9%) experienced the decompensation of CHF, which required intensive therapy. Conclusions In patients with EC and severe comorbidities, the surgery should optimally be performed in tertiary hospitals with different specialists available. These patients usually require an individual management approach to prevent possible complications. Long-term outcomes, including the survival rate and quality of life, are determined by the results of EC treatment itself and how concurrent diseases are managed.