Poupon Clothilde, Bendifallah Sofiane, Ouldamer Lobna, Canlorbe Geoffroy, Raimond Emilie, Hudry Nina, Coutant Charles, Graesslin Olivier, Touboul Cyril, Collinet Pierre, Bricou Alexandre, Huchon Cyrille, Daraï Emile, Ballester Marcos, Levêque Jean, Lavoue Vincent
CHU de Rennes, Service de Gynécologie, Hopital sud, Rennes, France.
Université de Rennes 1, Rennes, France.
Ann Surg Oncol. 2017 Jun;24(6):1667-1676. doi: 10.1245/s10434-016-5735-9. Epub 2016 Dec 22.
Little data exist about the clinical management and survival of elderly patients with endometrial cancer. This study aimed to evaluate the management of elderly and very elderly patients with endometrial cancer as well as the overall survival (OS) rate, disease-free survival (DFS) rate, and cancer-specific survival (CSS) rate in a multicenter cohort.
Data from 1228 patients with endometrial cancer who received primary treatment between January 2001 and December 2012 were collected from a multicenter database. Clinical management, DFS, CSS, and OS were analyzed.
Based on the international endometrial cancer risk classification, 36% (212/582) of women age 65 years or younger, 42% (220/526) of women ages 65-80 years, and 48% (58/120) of women older than 80 years showed high-risk endometrial cancer (p < 0.001). Pelvic lymphadenectomy was performed for 85% (230/271) of the women age 65 years or younger and 46% (33/71) of the women older than 80 years (p < 0.001). Radiotherapy was performed for 27% (33/120) of the very elderly and 40% (233/582) of the young patients (p = 0.009). The 3-year CSS rates were 95% (95% confidence interval [CI], 93-97%) for the women age 65 years or younger, 90% (95% CI, 87-94%) for the women ages 65-80 years, and 82% (95% CI, 73-93%) for the women older than 80 years (p < 0.001).
The elderly and very elderly patients with endometrial cancer showed poorer prognosis than young patients. The significant lower CSS rate for the elderly patients could have be due to both the higher rate of high-risk endometrial cancer and undertreatment. Specific guidelines for the management of elderly and very elderly patients with endometrial cancer are needed to improve their prognosis.
关于老年子宫内膜癌患者的临床管理和生存情况的数据较少。本研究旨在评估多中心队列中老年和高龄子宫内膜癌患者的管理情况以及总生存率（OS）、无病生存率（DFS）和癌症特异性生存率（CSS）。
从一个多中心数据库收集了2001年1月至2012年12月期间接受初次治疗的1228例子宫内膜癌患者的数据。分析了临床管理、DFS、CSS和OS情况。
根据国际子宫内膜癌风险分类，65岁及以下女性中有36%（212/582）、65 - 80岁女性中有42%（220/526）、80岁以上女性中有48%（58/120）表现为高危子宫内膜癌（p < 0.001）。65岁及以下女性中有85%（230/271）接受了盆腔淋巴结清扫术，80岁以上女性中有46%（33/71）接受了该手术（p < 0.001）。高龄患者中有27%（33/120）接受了放疗，年轻患者中有40%（233/582）接受了放疗（p = 0.009）。65岁及以下女性的3年CSS率为95%（95%置信区间[CI]，93 - 97%），65 - 80岁女性为90%（95% CI，87 - 94%），80岁以上女性为82%（95% CI，73 - 93%）（p < 0.001）。
老年和高龄子宫内膜癌患者的预后比年轻患者差。老年患者CSS率显著较低可能是由于高危子宫内膜癌发生率较高以及治疗不足。需要制定针对老年和高龄子宫内膜癌患者管理的具体指南以改善其预后。
