Abstract
Objective
With the population aging, development of safe and effective treatments for elderly
patients with cancer is needed. Although old age is considered a poor prognostic factor,
this is not only because of the patient’s disease condition or response to treatment,
but also because of treatment strategy and intensity. The purpose of this study was
to clarify the influence of age on treatment and prognosis in patients with cervical
cancer.
Methods
Women with stage Ib–IV cervical cancer treated at our institution between 1997 and
2014 were retrospectively analyzed. Patients were stratified by age into groups for
analysis, <65 years and ≥65 years. Categorical variables were compared using chi-squared
and Fisher’s exact tests. Survival analyses were performed using the Kaplan–Meier
method, and comparisons were made using the log-rank test. Subsequently, Cox proportional
hazards models were developed to find independent prognostic factors.
Results
Of 959 patients included in our study, 247 were ≥65 and 712 were <65 years of age.
Elderly patients tended to be at a more advanced stage than younger patients (p < 0.001).
Elderly patients more commonly had comorbidities. More received standard treatment
in the younger patient group at any disease stage than in the elderly patient group
(p < 0.001). Similar rates of adverse effects caused by surgery or radiotherapy were
seen in patients from both groups. Although overall survival was statistically shorter
in elderly patients (74.7 vs. 57.1%, p < 0.001), there was no significant difference
in disease-specific survival for patients treated only with standard treatment. In
multivariate analyses, clinical stage, histological type, treatment intensity, and
primary surgery remained independent prognostic factors. Age was not an independent
prognostic factor.
Conclusions
The influence of age on prognosis in patients with cervical cancer was less than we
expected. Elderly patients might have better outcomes depending on the type of standard
treatment they receive. The appropriate modality and intensity of treatment should
be based on the patient’s general condition and background.
Keywords
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Article info
Publication history
Published online: June 17, 2018
Accepted:
June 14,
2018
Received:
March 28,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
