Endometrial cancer of the very elderly: Management and survival in the Francogyn population

Published:January 10, 2023DOI:



      We aimed to describe management and survival of patients with endometrial cancer (EC) ≥80 years to identify poor prognosis criteria.


      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.


      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]).


      Our results suggest that very elderly patients with EC should receive adjuvant chemotherapy according to the standard care guidelines.



      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)
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      endometrial cancer
      Sentinel Node Procedure and Endometrial Cancer
      National College of French Obstetricians and Gynecologists
      body mass index
      International Federation of Gynecology and Obstetrics
      European Society for Medical Oncology
      European SocieTy for Radiotherapy & Oncology
      European Society of Gynecological Oncology
      lympho-vascular space invasion
      vaginal brachytherapy
      external beam radiotherapy
      high intermediate risk
      overall survival
      disease-free survival
      standard deviation
      hazard ratio
      confidence interval