Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation of Cancer Research, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan.
Cancer Chemother Pharmacol. 2019 Nov;84(5):1051-1058. doi: 10.1007/s00280-019-03938-8. Epub 2019 Sep 4.
Current strategies for the treatment of endometrial cancer in older adult patients require re-evaluation given the global trend in population aging, especially in Japan. We sought to evaluate initial treatment offered to older adult patients with endometrial cancer in Japan.
We retrospectively analyzed data on the standard treatment by age group in patients with endometrial cancer who underwent surgery between January 2005 and December 2013 at the National Cancer Center Hospital (Tokyo, Japan). Patients were stratified into four groups according to age: a younger group, aged 64 years or younger; older adult group 1, aged 65-69 years; older adult group 2, aged 70-74 years; and older adult group 3, aged ≥75 years.
Among 551 patients with endometrial cancer diagnosed and treated at our hospital, data from 531 eligible patients were analyzed. The proportion of patients in the older adult groups 1 or 2 who received standard treatment was the same as in the younger group. However, significantly fewer patients in older adult group 3 received standard treatment compared with the younger group (26% vs. 71%, p = 0.0001). Furthermore, the proportion of patients in older adult group 3 who underwent standard surgery was significantly lower than that in the younger group (26% vs. 72%, p = 0.0001).
The results indicate that age 75 years and older might represent a cutoff for the development of age-based treatment strategies for endometrial cancer. This information could be used to determine the upper age limit for participation in clinical trials in Japan.
鉴于全球人口老龄化趋势，尤其是在日本，需要重新评估目前针对老年子宫内膜癌患者的治疗策略。我们旨在评估日本老年子宫内膜癌患者的初始治疗方法。
我们回顾性分析了 2005 年 1 月至 2013 年 12 月在日本国家癌症中心医院接受手术的子宫内膜癌患者按年龄分组的标准治疗数据。根据年龄将患者分为四组：年龄<65 岁的年轻组、65-69 岁的老年组 1、70-74 岁的老年组 2 和≥75 岁的老年组 3。
在我院诊断和治疗的 551 例子宫内膜癌患者中，有 531 例符合条件的患者数据被分析。老年组 1 或 2 患者接受标准治疗的比例与年轻组相同。然而，老年组 3 患者接受标准治疗的比例明显低于年轻组（26% vs. 71%，p=0.0001）。此外，老年组 3 患者接受标准手术的比例明显低于年轻组（26% vs. 72%，p=0.0001）。
这些结果表明，年龄≥75 岁可能是制定基于年龄的子宫内膜癌治疗策略的截止点。这些信息可用于确定日本临床试验的年龄上限。
