Abstract
Objective
The goal of this study was to evaluate the demographic characteristics, pathology,
treatment, prognostic factors and survival rates in elderly patients with endometrial
cancer, and to compare their results with those of younger ones, in order to define
the specific characteristics of this malignancy in this population.
Study design: Retrospective analysis of all endometrial cancer patients managed at
the University Hospital of the Canary Islands (Spain) between 1990 and 2016. Survival
curves were calculated by using the Kaplan-Meier method and compared with the log-rank
test. Logistic regression analysis was used to assess the independent effect of different
variables on cancer-specific survival. Statistical significance was considered for
p < 0.05.
Results
The study included 1799 endometrial cancer patients; 170 of them (9.4%) were 80 years
old or older. Elderly patients received less surgery (68.2% vs. 92.4%), lymphadenectomy
(10.3% vs. 26.2%) and adjuvant treatment (37.1% vs. 51.2%) than younger ones, and
presented higher probability of receiving palliative treatment (27.6% vs. 4%). Endometrioid
tumors were more frequently diagnosed in younger patients (78.8% vs. 62.9%), while
type 2-endometrial cancer was more frequently diagnosed in elderly ones (37.1% vs.
21.2%).
Cancer-specific survival in older patients was significantly poorer than in younger
ones, with a mean of 61.4 months (95%CI 51.7–71.1) versus 226 months (95%CI 218.9–233.1),
respectively. In a multivariate analysis: age, FIGO stage, histology, tumor differentiation
and adjuvant treatment were independently associated with survival.
Conclusion
Although endometrial cancer is more aggressive in older patients, they are less likely
to receive optimal treatment, which negatively affects their survival. Specific guidelines
for the management of this population, including a comprehensive geriatric assessment,
should be developed to improve their prognosis.
Keywords
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Article info
Publication history
Published online: September 17, 2019
Accepted:
September 14,
2019
Received in revised form:
September 8,
2019
Received:
March 15,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
