Prognostic factors of endometrial cancer in elderly patient group and their effects on survival

Yıl: 2021 Cilt: 8 Sayı: 4 Sayfa Aralığı: 345 - 353 Metin Dili: İngilizce DOI: 10.14744/nci.2020.47154 İndeks Tarihi: 21-01-2022

Prognostic factors of endometrial cancer in elderly patient group and their effects on survival

Öz:
OBJECTIVE: The objective of the study was to investigate the prognostic factors of the elderly group and their effects on survival by examining the histopathological features, surgical treatment protocols, and treatment modalities of patients diagnosed with endometrial cancer (EC). METHODS: The records of 397 EC patients who completed their treatment and follow-up at a single center between 2012 and 2019 were evaluated retrospectively. The patients were evaluated in two groups as <70 years old (n: 301; 75.8%) and >70 years old (n: 96; 24.2%). Following the evaluation of histopathological features and treatment protocols, independent risk factors influencing survival were investigated with the Cox regression model. RESULTS: The incidence of non-endometrioid histology (16.3% vs. 32.3%, p: 0.001), high-grade tumors (50.5% vs. 69.8%; p: 0.001), and >50 myometrial invasion (19.6% vs. 36.5%, p: 0.003) in the >70 age group was more frequent than that in the <70 age group. The independent risk factors on overall survival in the >70 age group were determined as non-endometrioid histology (HR: 5.9; 95% CI: 1.4– 24.7) and lymph node metastasis (HR: 6.4; 95% CI: 1.6–25.0). In the <70 age group, non-endometrioid histology (HR: 11.3; 95% CI: 4.0–32.0) was identified as the only independent risk factor affecting 5-year survival. CONCLUSION: EC, with non-endometrioid histology, which is observed at a higher rate in elderly patients despite equal surgery and adjuvant therapy, is the primary factor that affects survival.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Society AC. Cancer Facts and Figures 2019. Available at: https://www. cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/ cancer-facts-figures-2019.html. Accessed Mar 25, 2021.
  • 2. Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, et al; ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, treatment and follow-up. Int J Gynecol Cancer 2016;26:2–30.
  • 3. National Cancer Institute. Surveillance, Epidemiology, and End Results Program 2020. Available at: https://seer.cancer.gov/statfacts/html/ corp.html. Accessed Jul 09, 2021.
  • 4. Wright JD, Lewin SN, Barrena Medel NI, Sun X, Burke WM, Deutsch I, et al. Endometrial cancer in the oldest old: Tumor characteristics, patterns of care, and outcome. Gynecol Oncol 2011;122:69–74.
  • 5. Lachance JA, Everett EN, Greer B, Mandel L, Swisher E, Tamimi H, et al. The effect of age on clinical/pathologic features, surgical morbidity, and outcome in patients with endometrial cancer. Gynecol Oncol 2006;101:470–5.
  • 6. World population aging: clocks illustrate growth in population under age 5 and over age 65. Available at: https://www.prb.org/agingpopulationclocks/. Accessed Mar 25, 2021.
  • 7. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013;63:11–30.
  • 8. Rousselin A, Bendifallah S, Nyangoh Timoh K, Ouldamer L, Canlorbe G, Raimond E, et al. Patterns of care and the survival of elderly patients with high-risk endometrial cancer: A case-control study from the FRANCOGYN group. Eur J Surg Oncol 2017;43:2135– 42.
  • 9. Bourgin C, Lambaudie E, Houvenaeghel G, Foucher F, Levêque J, Lavoué V. Impact of age on surgical staging and approaches (laparotomy, laparoscopy and robotic surgery) in endometrial cancer management. Eur J Surg Oncol 2017;43:703–9.
  • 10. Eggemann H, Ignatov T, Burger E, Costa SD, Ignatov A. Management of elderly women with endometrial cancer. Gynecol Oncol 2017;146:519–24.
  • 11. Benito V, Lubrano A, Andújar M, Mori M, Federico M. Management of endometrial cancer in patients aged 80 years and older: identifying patients who may benefit from a curative treatment. Eur J Obstet Gynecol Reprod Biol 2019;242:36–42.
  • 12. Alektiar KM, Venkatraman E, Abu-Rustum N, Barakat RR. Is endometrial carcinoma intrinsically more aggressive in elderly patients? Cancer 2003;98:2368–77.
  • 13. Okuma K, Yamashita H, Kawana K, Nakagawa S, Oda K, Nakagawa K. Advanced age is a significant determinant of poor prognosis in patients treated with surgery plus postoperative radiotherapy for endometrial cancer. J Obstet Gynaecol Res 2010;36:757–63.
  • 14. Koual M, Ngo C, Girault A, Lécuru F, Bats AS. Endometrial cancer in the elderly: does age influence surgical treatments, outcomes, and prognosis? Menopause 2018;25:968–76.
  • 15. Türkiye İstatistik Kurumu: Türkiye’de ortalama yaşam süresi 2019. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Hayat-Tablolari-2013-2014-18618. Accessed Oct 10, 2020.
  • 16. Clark LH, Jackson AL, Gehrig PA, Bae-Jump V, Van Le L, Ko EM. Adjuvant treatment and clinical trials in elderly patients with endometrial cancer: a time for change? Int J Gynecol Cancer 2016;26:282–9.
  • 17. De Marzi P, Ottolina J, Mangili G, Rabaiotti E, Ferrari D, Viganò R, et al. Surgical treatment of elderly patients with endometrial cancer (≥ 65 years). J Geriatr Oncol 2013;4:368–73.
  • 18. Günakan E, Atak Z, Albayrak M, Kurban Y, Şimşek GG. Endometrial histopathology results and evaluation of endometrial cancer risk in geriatric women. Prz Menopauzalny 2018;17:18–21.
  • 19. Torgeson A, Boothe D, Poppe MM, Suneja G, Gaffney DK. Disparities in care for elderly women with endometrial cancer adversely effects survival. Gynecol Oncol 2017;147:320–8.
  • 20. Bourgin C, Saidani M, Poupon C, Cauchois A, Foucher F, Leveque J, et al. Endometrial cancer in elderly women: Which disease, which surgical management? A systematic review of the literature. Eur J Surg Oncol 2016;42:166–75.
  • 21. Bishop EA, Java JJ, Moore KN, Spirtos NM, Pearl ML, Zivanovic O, et al. Surgical outcomes among elderly women with endometrial cancer treated by laparoscopic hysterectomy: a NRG/Gynecologic Oncology Group study. Am J Obstet Gynecol 2018;218:109.e1–109.e11.
  • 22. Mouraz M, Ferreira CS, Gonçalves S, Martins NN, Martins FN. Laparoscopic approach in surgical staging of endometrial cancer. Rev Bras Ginecol Obstet 2019;41:306–11.
  • 23. Münstedt K, von Georgi R, Misselwitz B, Zygmunt M, Stillger R, Künzel W. Centralizing surgery for gynecologic oncology-a strategy assuring better quality treatment? Gynecol Oncol 2003;89:4–8.
  • 24. Mariani A, Dowdy SC, Cliby WA, Gostout BS, Jones MB, Wilson TO, et al. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol 2008;109:11–8.
  • 25. Frost JA, Webster KE, Bryant A, Morrison J. Lymphadenectomy for the management of endometrial cancer. Cochrane Database Syst Rev 2017;10:CD007585.
  • 26. Bogani G, Murgia F, Ditto A, Raspagliesi F. Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol 2019;153:676–83.
  • 27. Seagle BL, Gilchrist-Scott D, Graves S, Strohl AE, Nieves-Neira W, Shahabi S. Association of lymph node count and overall survival in node-negative endometrial cancers. JCO Clin Cancer Inform 2017;1:10.1200/CCI.16.00064.
  • 28. Zhao L, Li L, Ye Y, Han X, Fu X, Yu Y, et al. Lymphadenectomy and prognosis for elderly females with stage I endometrioid endometrial cancer. Arch Gynecol Obstet 2019;300:683–91.
  • 29. Fiorentino A, Chiumento C, Fusco V. Do comorbidity influences acute toxicity and outcome in elderly patients with endometrial cancer treated by adjuvant radiotherapy plus brachytherapy? Clin Transl Oncol 2013;15:665–9.
  • 30. Palaia I, Loprete E, Musella A, Marchetti C, Di Donato V, Bellati F, et al. Chemotherapy in elderly patients with gynecological cancer. Oncology 2013;85:168–72.
APA Alemdaroglu S, Doğan Durdağ G, Yılmaz Baran Ş, yuksel simsek s, Yetkinel S, ALKAŞ YAĞINÇ D, Guler O, Celik H (2021). Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. , 345 - 353. 10.14744/nci.2020.47154
Chicago Alemdaroglu Songul,Doğan Durdağ Gülşen,Yılmaz Baran Şafak,yuksel simsek seda,Yetkinel Selçuk,ALKAŞ YAĞINÇ DİDEM,Guler Ozan Cem,Celik Husnu Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. (2021): 345 - 353. 10.14744/nci.2020.47154
MLA Alemdaroglu Songul,Doğan Durdağ Gülşen,Yılmaz Baran Şafak,yuksel simsek seda,Yetkinel Selçuk,ALKAŞ YAĞINÇ DİDEM,Guler Ozan Cem,Celik Husnu Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. , 2021, ss.345 - 353. 10.14744/nci.2020.47154
AMA Alemdaroglu S,Doğan Durdağ G,Yılmaz Baran Ş,yuksel simsek s,Yetkinel S,ALKAŞ YAĞINÇ D,Guler O,Celik H Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. . 2021; 345 - 353. 10.14744/nci.2020.47154
Vancouver Alemdaroglu S,Doğan Durdağ G,Yılmaz Baran Ş,yuksel simsek s,Yetkinel S,ALKAŞ YAĞINÇ D,Guler O,Celik H Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. . 2021; 345 - 353. 10.14744/nci.2020.47154
IEEE Alemdaroglu S,Doğan Durdağ G,Yılmaz Baran Ş,yuksel simsek s,Yetkinel S,ALKAŞ YAĞINÇ D,Guler O,Celik H "Prognostic factors of endometrial cancer in elderly patient group and their effects on survival." , ss.345 - 353, 2021. 10.14744/nci.2020.47154
ISNAD Alemdaroglu, Songul vd. "Prognostic factors of endometrial cancer in elderly patient group and their effects on survival". (2021), 345-353. https://doi.org/10.14744/nci.2020.47154
APA Alemdaroglu S, Doğan Durdağ G, Yılmaz Baran Ş, yuksel simsek s, Yetkinel S, ALKAŞ YAĞINÇ D, Guler O, Celik H (2021). Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. İstanbul Kuzey Klinikleri, 8(4), 345 - 353. 10.14744/nci.2020.47154
Chicago Alemdaroglu Songul,Doğan Durdağ Gülşen,Yılmaz Baran Şafak,yuksel simsek seda,Yetkinel Selçuk,ALKAŞ YAĞINÇ DİDEM,Guler Ozan Cem,Celik Husnu Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. İstanbul Kuzey Klinikleri 8, no.4 (2021): 345 - 353. 10.14744/nci.2020.47154
MLA Alemdaroglu Songul,Doğan Durdağ Gülşen,Yılmaz Baran Şafak,yuksel simsek seda,Yetkinel Selçuk,ALKAŞ YAĞINÇ DİDEM,Guler Ozan Cem,Celik Husnu Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. İstanbul Kuzey Klinikleri, vol.8, no.4, 2021, ss.345 - 353. 10.14744/nci.2020.47154
AMA Alemdaroglu S,Doğan Durdağ G,Yılmaz Baran Ş,yuksel simsek s,Yetkinel S,ALKAŞ YAĞINÇ D,Guler O,Celik H Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. İstanbul Kuzey Klinikleri. 2021; 8(4): 345 - 353. 10.14744/nci.2020.47154
Vancouver Alemdaroglu S,Doğan Durdağ G,Yılmaz Baran Ş,yuksel simsek s,Yetkinel S,ALKAŞ YAĞINÇ D,Guler O,Celik H Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. İstanbul Kuzey Klinikleri. 2021; 8(4): 345 - 353. 10.14744/nci.2020.47154
IEEE Alemdaroglu S,Doğan Durdağ G,Yılmaz Baran Ş,yuksel simsek s,Yetkinel S,ALKAŞ YAĞINÇ D,Guler O,Celik H "Prognostic factors of endometrial cancer in elderly patient group and their effects on survival." İstanbul Kuzey Klinikleri, 8, ss.345 - 353, 2021. 10.14744/nci.2020.47154
ISNAD Alemdaroglu, Songul vd. "Prognostic factors of endometrial cancer in elderly patient group and their effects on survival". İstanbul Kuzey Klinikleri 8/4 (2021), 345-353. https://doi.org/10.14744/nci.2020.47154