Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT)

Vanbraband, Joren; Van Damme, Nancy; Bouche, Gauthier; Silversmit, Geert; De Geyndt, Anke; de Jonge, Eric; Jacomen, Gerd; Goffin, Frédéric; Denys, Hannelore; Amant, Frédéric

doi:10.1186/s12885-022-09671-5

Table 2 Patient, tumor and treatment characteristics

From: Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT)

	All patients (n = 6599)		REP (n = 3724)^a		Non-REP (n = 583)^a		Non-Effect-A (n = 471)^a		Non-Effect-B (n = 1821)^a
Characteristics	N	%	N	%	N	%	N	%	N	%
Age group
< 60 years	1244	18.9%	749	20.1%	111	19.0%	78	16.6%	306	16.8%
60–79 years	3998	60.6%	2273	61.0%	322	55.2%	295	62.6%	1108	60.8%
≥ 80 years	1357	20.6%	702	18.9%	150	25.7%	98	20.8%	407	22.4%
WHO score^b
Known	5733	86.9%	3416	91.7%	450	77.2%	416	88.3%	1451	79.7%
0	1417	24.7%	930	27.2%	70	15.6%	58	13.9%	359	24.7%
1	3988	69.6%	2301	67.4%	337	74.9%	334	80.3%	1016	70.0%
≥ 2	328	5.7%	185	5.4%	43	9.6%	24	5.8%	76	5.2%
Missing	866	13.1%	308	8.3%	133	22.8%	55	11.7%	370	20.3%
Comorbidity index^c
Known	6522	98.8%	3685	99.0%	577	99.0%	465	98.7%	1795	98.6%
0	2318	35.5%	1339	36.3%	213	36.9%	159	34.2%	607	33.8%
1	3000	46.0%	1679	45.6%	269	46.6%	217	46.7%	835	46.5%
≥ 2	1204	18.5%	667	18.1%	95	16.5%	89	19.1%	353	19.7%
Missing	77	1.2%	39	1.0%	6	1.0%	6	1.3%	26	1.4%
Number of inpatient bed days in year prior to diagnosis
0 days	4078	61.8%	2362	63.4%	311	53.3%	289	61.4%	1116	61.3%
1–5 days	1683	25.5%	931	25.0%	172	29.5%	114	24.2%	466	25.6%
6–15 days	480	7.3%	249	6.7%	61	10.5%	41	8.7%	129	7.1%
> 15 days	358	5.4%	182	4.9%	39	6.7%	27	5.7%	110	6.0%
Multiple tumor status^d
No	6267	95.0%	3541	95.1%	541	92.8%	448	95.1%	1737	95.4%
Yes	332	5.0%	183	4.9%	42	7.2%	23	4.9%	84	4.6%
Center volume
Low (< 10/year)	1496	22.7%	520	14.0%	58	9.9%	61	13.0%	857	47.1%
Medium (10–19/year)	2106	31.9%	1210	32.5%	156	26.8%	219	46.5%	521	28.6%
High (≥ 20/year)	2997	45.4%	1994	53.5%	369	63.3%	191	40.6%	443	24.3%
Incidence year
2012	1350	20.5%	684	18.4%	93	16.0%	174	36.9%	399	21.9%
2013	1265	19.2%	717	19.3%	135	23.2%	63	13.4%	350	19.2%
2014	1342	20.3%	848	22.8%	108	18.5%	20	4.2%	366	20.1%
2015	1332	20.2%	788	21.2%	129	22.1%	59	12.5%	356	19.5%
2016	1310	19.9%	687	18.4%	118	20.2%	155	32.9%	350	19.2%
Combined stage^e
Known	6234	94.5%	3615	97.1%	494	84.7%	437	92.8%	1688	92.7%
Stage 0-II	4948	79.4%	2871	79.4%	366	74.1%	355	81.2%	1356	80.3%
Stage III	744	11.9%	455	12.6%	61	12.3%	41	9.4%	187	11.1%
Stage IV	542	8.7%	289	8.0%	67	13.6%	41	9.4%	145	8.6%
Missing (stage X)	365	5.5%	109	2.9%	89	15.3%	34	7.2%	133	7.3%
Histologic type^f
Carcinoma (epithelial)	6302	95.5%	3558	95.5%	528	90.6%	453	96.2%	1763	96.8%
Type I	4073	64.6%	2354	66.2%	318	60.2%	295	65.1%	1106	62.7%
Type II	1812	28.8%	1042	29.3%	149	28.2%	136	30.0%	485	27.5%
Other	417	6.6%	162	4.6%	61	11.6%	22	4.9%	172	9.8%
Sarcoma (mesenchymal)	297	4.5%	166	4.5%	55	9.4%	18	3.8%	58	3.2%
Differentiation grade^g
Known	6181	93.7%	3561	95.6%	522	89.5%	449	95.3%	1649	90.6%
Low-grade (G1-2)	4170	67.5%	2414	67.8%	325	62.3%	304	67.7%	1127	68.3%
High-grade (G3-4)	2011	32.5%	1147	32.2%	197	37.7%	145	32.3%	522	31.7%
Missing	418	6.3%	163	4.4%	61	10.5%	22	4.7%	172	9.4%
Type of primary treatment^h
No treatment	395	6.0%	156	4.2%	73	12.5%	40	8.5%	126	6.9%
Other type	472	7.2%	249	6.7%	69	11.8%	25	5.3%	129	7.1%
Curative surgery	5732	86.9%	3319	89.1%	441	75.6%	406	86.2%	1566	86.0%
Surgery only	3607	62.9%	2125	64.0%	283	64.2%	260	64.0%	939	60.0%
Surgery + (neo)adj. treatment	2125	37.1%	1194	36.0%	158	35.8%	146	36.0%	627	40.0%
Type of surgeryⁱ
No surgery	867	13.1%	405	10.9%	142	24.4%	65	13.8%	255	14.0%
Surgery	5732	86.9%	3319	89.1%	441	75.6%	406	86.2%	1566	86.0%
TH	3084	53.8%	1838	55.4%	245	55.6%	196	48.3%	805	51.4%
TRH	2137	37.3%	1173	35.3%	142	32.2%	163	40.1%	659	42.1%
Debulking	432	7.5%	270	8.1%	44	10.0%	42	10.3%	76	4.9%
Other type	79	1.4%	38	1.1%	10	2.3%	5	1.2%	26	1.7%
MDT meeting^j
No	480	7.3%	125	3.4%	112	19.2%	46	9.8%	197	10.8%
Yes	6119	92.7%	3599	96.6%	471	80.8%	425	90.2%	1624	89.2%
Biopsy (diagnostic)
No	1419	21.5%	780	20.9%	181	31.0%	92	19.5%	366	20.1%
Yes	5180	78.5%	2944	79.1%	402	69.0%	379	80.5%	1455	79.9%
Imaging (diagnostic)
No	68	1.0%	39	1.0%	9	1.5%	3	0.6%	17	0.9%
Yes	6531	99.0%	3685	99.0%	574	98.5%	468	99.4%	1804	99.1%
30-day post-operative mortality^k
Not applicable (NA)	868	13.2%	406	10.9%	142	24.4%	65	13.8%	255	14.0%
Applicable	5731	86.8%	3318	89.1%	441	75.6%	406	86.2%	1566	86.0%
No	5694	99.4%	3306	99.6%	431	97.7%	406	100.0%	1551	99.0%
Yes	37	0.6%	12	0.4%	10	2.3%	0	0.0%	15	1.0%

^aREP = Registered EFFECT-Patients, Non-REP = Non-Registered EFFECT-Patients, Non-EFFECT-A = non-registered patients treated outside of the active registration period of a participating center, Non-EFFECT-B = non-registered patients treated in a non-participating center
^bWorld Health Organization (WHO) performance status score, expressing the patient’s general health condition at diagnosis, ranging from 0 (asymptomatic) to 4 (completely disabled/bedbound) [22]
^cIndex quantifying the prevalence of three major chronic comorbid conditions (i.e., diabetes mellitus, chronic cardiovascular disease, and chronic respiratory disease), ranging from 0 (no comorbidity present) to 3 (all three comorbidities present) [23]
^dWhether another primary cancer was present in the 5-year period prior to diagnosis, regardless of topography and morphology, except non-melanoma skin cancer
^eComposite measure of clinical and pathological stage: pathological stage always prevailed over clinical stage, except when clinical stage was IVB (clinical proof of distant metastasis) or pathological stage was missing
^fCarcinomas were classified in type I (low-grade carcinomas of endometrioid, mucinous or unspecified histology), type II (all high-grade carcinomas, including those of endometrioid, mucinous or unspecified histology), and other carcinomas (of endometrioid, mucinous or unspecified histology and unknown differentiation grade)
^gLow-grade = well or moderately differentiated (grade 1 or 2), high-grade = poorly or undifferentiated (grade 3 or 4)
^hOther type = curative or palliative chemo-, radio- and/or hormone therapy
ⁱTH = total hysterectomy, TRH = total radical hysterectomy
^jMultidisciplinary tumor board (MDT)
^kNA = patients that did not undergo surgery, or were lost to follow-up within the first 30 days post-surgery

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