The impact of therapeutic management on survival of elderly women with endometrial cancer

Objectives. - We aimed to determine whether patients characteristics, clinicopathologic features and survival rates were worse in elderly women with endometrial cancer. Patients and methods. - The study cohort consisted of consecutive women undergoing surgery for endometrial cancer in our institution from January 2000 to October 2011. Patients were divided by age into two groups: patients aged 65 to 79 and those aged 80 or older. Clinical data included comorbidities, BMI (kg/m(2)), surgical procedures, surgical International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade, relevant prognostic factors, occurrence of perioperative complications, adjuvant therapies, overall survival and long term disease specific mortality. Results. - As expected, elderly women had more major comorbidities and were less likely to undergo optimal surgery. FIGO stages, histological grades. The 5-year disease specific survival was significantly poorer for the older group compared to younger women 64.5% 95%CI [54.3-73.8] vs 83.49% 95%CI 174.7-90.2] P=0.008. Cancer-specific mortality was also higher in the elderly: 100% vs 41.17% (P=0.005). Discussion and conclusion. - Oldest patients with newly diagnosed endometrial cancer were found to have worse overall survival and higher cancer-specific mortality than younger patients because of less aggressive care. Clinical efforts must be managed toward the oldest patients with an early stage of endometrial cancer to maximize the therapeutic ratio, in particular surgical. (C) 2012 Elsevier Masson SAS. All rights reserved.