OBJECTIVE: We evaluated prognostic, demographic and outcome data for patients>80 years old with uterine cancer (UC). METHODS: A retrospective review of clinical records was performed. Categorical data were compared using Fisher's exact test and Kaplan-Meier for survival data. RESULTS: Sixty-five patients were identified with a mean age of 84 and BMI 27. Sixty-five percent of patients had medical co-morbidities. Forty-two (65%) were Stage I; 10 (15%) were Stage II; 8 (12%) were Stage III; and 5 (8%) were Stage IV. Stage I patients included those identified via hysterectomy with lymph nodes (LND) (30) or clinical impression (12). Comparing clinically Stage I UC to those with LND, the clinical group was older (86 vs. 83; p=0.01) and tended to have more medical co-morbidity (89% vs. 63%; p=0.14). Two-year overall survival (OS) among unstaged vs. staged patients was 62% vs. 77%; p=0.11. Among staged patients with Stage I UC, 21 (70%) met high intermediate risk (HIR) criteria per GOG 99 and 90% received no adjuvant therapy. Three patients (16%) recurred with 1 (5%) locoregional recurrence. Two-year OS is 77%. CONCLUSION: Elderly patients with UC have features associated with extrauterine spread. Both clinically and surgically staged Stage I patients had excellent OS at 2 years despite no adjuvant therapy. Prevalent medical co-morbidities may impact survival more than recurrence risk. The 23% recurrence rate among HIR patients in GOG 99 was not observed in our data, suggesting that observation for elderly Stage I patients is acceptable.
OBJECTIVE: We evaluated prognostic, demographic and outcome data for patients>80 years old with uterine cancer (UC). METHODS: A retrospective review of clinical records was performed. Categorical data were compared using Fisher's exact test and Kaplan-Meier for survival data. RESULTS: Sixty-five patients were identified with a mean age of 84 and BMI 27. Sixty-five percent of patients had medical co-morbidities. Forty-two (65%) were Stage I; 10 (15%) were Stage II; 8 (12%) were Stage III; and 5 (8%) were Stage IV. Stage I patients included those identified via hysterectomy with lymph nodes (LND) (30) or clinical impression (12). Comparing clinically Stage I UC to those with LND, the clinical group was older (86 vs. 83; p=0.01) and tended to have more medical co-morbidity (89% vs. 63%; p=0.14). Two-year overall survival (OS) among unstaged vs. staged patients was 62% vs. 77%; p=0.11. Among staged patients with Stage I UC, 21 (70%) met high intermediate risk (HIR) criteria per GOG 99 and 90% received no adjuvant therapy. Three patients (16%) recurred with 1 (5%) locoregional recurrence. Two-year OS is 77%. CONCLUSION: Elderly patients with UC have features associated with extrauterine spread. Both clinically and surgically staged Stage I patients had excellent OS at 2 years despite no adjuvant therapy. Prevalent medical co-morbidities may impact survival more than recurrence risk. The 23% recurrence rate among HIR patients in GOG 99 was not observed in our data, suggesting that observation for elderly Stage I patients is acceptable.
Authors: M Patrick Lowe; Saurabh Kumar; Peter R Johnson; Scott A Kamelle; Donald H Chamberlain; Todd D Tillmanns Journal: J Robot Surg Date: 2010-06-11