Abstract
Introduction
We aimed to describe management and survival of patients with endometrial cancer (EC)
≥80 years to identify poor prognosis criteria.
Methods
We collected clinical, histologic, surgical and follow-up data for patients with EC ≥ 80
years included in a multicenter French cohort (FRANCOGYN) who underwent primary surgical
treatment from 1999 to 2019. The outcomes were overall survival (OS) and disease-free
survival (DFS). We performed a descriptive analysis then a survival time analysis
and comparison using the Kaplan Meier method and log-rank test.
Results
Of the 1647 patients with EC who received treatment during the study period, 184 (11.17%)
were ≥80 years. The mean age was 84 years (±3.34). Thirty-three patients (25.4%) died
during the follow-up period and 26 relapsed (18.4%). Forty-nine patients were lost
to follow-up (27.37%). The median follow-up time was 15.3 months (4.9–28.8). The median
OS and DFS was 16.4 months (6.3–24.9) and 13.6 months (4.5–26.6), respectively. Eighty-three
patients received adjuvant therapy (45.11%), out of 95 who had a formal or relative
indication. Four patients received adjuvant chemotherapy (2.6%), out of 61 who had
a formal or relative indication. Inappropriate or underuse of chemotherapy was significantly
associated with a lower median OS of 12.6 months [3.73–24] versus 17.3 months [7.93–41.77]
when performed appropriately (HR = 4.14, CI 95% [1.62–10.56]), and a lower median
DFS of 10.83 months [3.73–24] versus 17.3 months [7.93–28.5] (HR = 9.04, CI 95% [2.04–40.12]).
Conclusion
Our results suggest that very elderly patients with EC should receive adjuvant chemotherapy
according to the standard care guidelines.
Keywords
Abbreviations:
EC (Endometrial Cancer), SENTI-ENDO (Sentinel Node Procedure and Endometrial Cancer), CNGOF (National College of French Obstetricians and Gynecologists), BMI (Body Mass Index), FIGO (Internationel Federation of Gynecology and Obstetrics), ESMO (European Society for Medical Oncology), ESTRO (European SocieTy for Radiotherapy and Oncology), ESGO (European Society for Gynecological Oncology), LVSI (Lymphovascular Space invasion), VBT (Vaginal BrachyTherapy), EBRT (External Beam RadioTherapy), CT (ChemoTherapy), RT (RadioTherapy), HIR (High Intermediate Risk), OS (Overall Survival), DFS (Disease-Free Survival), SD (Standard Deviation), HR (Hazard Ratio), CI (Confidence Interval)To read this article in full you will need to make a payment
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Index
ECendometrial cancer
SENTI-ENDOSentinel Node Procedure and Endometrial Cancer
CNGOFNational College of French Obstetricians and Gynecologists
BMIbody mass index
FIGOInternational Federation of Gynecology and Obstetrics
ESMOEuropean Society for Medical Oncology
ESTROEuropean SocieTy for Radiotherapy & Oncology
ESGOEuropean Society of Gynecological Oncology
LVSIlympho-vascular space invasion
VBTvaginal brachytherapy
EBRTexternal beam radiotherapy
CTchemotherapy
RTradiotherapy
HIRhigh intermediate risk
OSoverall survival
DFSdisease-free survival
SDstandard deviation
HRhazard ratio
CIconfidence interval
Article info
Publication history
Published online: January 10, 2023
Accepted:
January 9,
2023
Received in revised form:
December 14,
2022
Received:
July 12,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
