Clothilde Poupon1,2,3, Sofiane Bendifallah3,4,5, Lobna Ouldamer6, Geoffroy Canlorbe4, Emilie Raimond7, Nina Hudry8, Charles Coutant8, Olivier Graesslin7, Cyril Touboul9, Pierre Collinet10, Alexandre Bricou11, Cyrille Huchon12, Emile Daraï4,13, Marcos Ballester4,13, Jean Levêque1,2,3, Vincent Lavoue14,15,16,17. 1. CHU de Rennes, Service de Gynécologie, Hopital sud, Rennes, France. 2. Université de Rennes 1, Rennes, France. 3. Oncogenesis, Stress and Signaling, CRLCC Eugène Marquis, Rennes, France. 4. Department of Gynaecology and Obstetrics, Institut Universitaire de Cancérologie (IUC), Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Paris, France. 5. INSERM UMR_S_707, EpidemiologyInformation SystemsModeling, University Pierre and Marie Curie, Paris 6, Paris, France. 6. Department of Obstetrics and Gynaecology, Centre hospitalier régional universitaire de Tours, Hôpital Bretonneau, Tours, France. 7. Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France. 8. Centre de Lutte Contre le Cancer Georges François Leclerc, Dijon, France. 9. Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France. 10. Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire, Lille, France. 11. Department of Gynaecology and Obstetrics, Jean Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris 13, Villetaneuse, France. 12. Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal, Poissy, France. 13. INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, Paris, France. 14. CHU de Rennes, Service de Gynécologie, Hopital sud, Rennes, France. vincent.lavoue@chu-rennes.fr. 15. Université de Rennes 1, Rennes, France. vincent.lavoue@chu-rennes.fr. 16. Oncogenesis, Stress and Signaling, CRLCC Eugène Marquis, Rennes, France. vincent.lavoue@chu-rennes.fr. 17. Service de Gynécologie, CHU de Rennes, Rennes, France. vincent.lavoue@chu-rennes.fr.
Abstract
BACKGROUND: Little data exist about the clinical management and survival of elderly patients with endometrial cancer. This study aimed to evaluate the management of elderly and very elderly patients with endometrial cancer as well as the overall survival (OS) rate, disease-free survival (DFS) rate, and cancer-specific survival (CSS) rate in a multicenter cohort. METHODS: Data from 1228 patients with endometrial cancer who received primary treatment between January 2001 and December 2012 were collected from a multicenter database. Clinical management, DFS, CSS, and OS were analyzed. RESULTS: Based on the international endometrial cancer risk classification, 36% (212/582) of women age 65 years or younger, 42% (220/526) of women ages 65-80 years, and 48% (58/120) of women older than 80 years showed high-risk endometrial cancer (p < 0.001). Pelvic lymphadenectomy was performed for 85% (230/271) of the women age 65 years or younger and 46% (33/71) of the women older than 80 years (p < 0.001). Radiotherapy was performed for 27% (33/120) of the very elderly and 40% (233/582) of the young patients (p = 0.009). The 3-year CSS rates were 95% (95% confidence interval [CI], 93-97%) for the women age 65 years or younger, 90% (95% CI, 87-94%) for the women ages 65-80 years, and 82% (95% CI, 73-93%) for the women older than 80 years (p < 0.001). CONCLUSIONS: The elderly and very elderly patients with endometrial cancer showed poorer prognosis than young patients. The significant lower CSS rate for the elderly patients could have be due to both the higher rate of high-risk endometrial cancer and undertreatment. Specific guidelines for the management of elderly and very elderly patients with endometrial cancer are needed to improve their prognosis.
BACKGROUND: Little data exist about the clinical management and survival of elderly patients with endometrial cancer. This study aimed to evaluate the management of elderly and very elderly patients with endometrial cancer as well as the overall survival (OS) rate, disease-free survival (DFS) rate, and cancer-specific survival (CSS) rate in a multicenter cohort. METHODS: Data from 1228 patients with endometrial cancer who received primary treatment between January 2001 and December 2012 were collected from a multicenter database. Clinical management, DFS, CSS, and OS were analyzed. RESULTS: Based on the international endometrial cancer risk classification, 36% (212/582) of women age 65 years or younger, 42% (220/526) of women ages 65-80 years, and 48% (58/120) of women older than 80 years showed high-risk endometrial cancer (p < 0.001). Pelvic lymphadenectomy was performed for 85% (230/271) of the women age 65 years or younger and 46% (33/71) of the women older than 80 years (p < 0.001). Radiotherapy was performed for 27% (33/120) of the very elderly and 40% (233/582) of the young patients (p = 0.009). The 3-year CSS rates were 95% (95% confidence interval [CI], 93-97%) for the women age 65 years or younger, 90% (95% CI, 87-94%) for the women ages 65-80 years, and 82% (95% CI, 73-93%) for the women older than 80 years (p < 0.001). CONCLUSIONS: The elderly and very elderly patients with endometrial cancer showed poorer prognosis than young patients. The significant lower CSS rate for the elderly patients could have be due to both the higher rate of high-risk endometrial cancer and undertreatment. Specific guidelines for the management of elderly and very elderly patients with endometrial cancer are needed to improve their prognosis.
Authors: Á Rovirosa; K S Cortés; C Ascaso; A Glickman; S Valdés; A Herreros; C Camacho; J Sánchez; Y Zhang; Y Li; S Sabater; M Arenas; A Torne Journal: Clin Transl Oncol Date: 2018-04-12 Impact factor: 3.405
Authors: Clark DuMontier; Kah Poh Loh; Paul A Bain; Rebecca A Silliman; Tammy Hshieh; Gregory A Abel; Benjamin Djulbegovic; Jane A Driver; William Dale Journal: J Clin Oncol Date: 2020-04-06 Impact factor: 50.717