Department of Geriatrics, Hospital of Champmaillot, Dijon University Hospital, Dijon, France; Geriatric Oncology Coordination Unit in Burgundy, Hospital of Champmaillot, Dijon University Hospital, France; Côte d'Or Breast and Gynecological Cancer Registry, George-François Leclerc Cancer Centre, Dijon, France; Epidemiology and Quality of Life Research Unit, INSERM U1231, George-François Leclerc Cancer Centre, Dijon, France.
Côte d'Or Breast and Gynecological Cancer Registry, George-François Leclerc Cancer Centre, Dijon, France; Epidemiology and Quality of Life Research Unit, INSERM U1231, George-François Leclerc Cancer Centre, Dijon, France.
Maturitas. 2022 Apr;158:40-46. doi: 10.1016/j.maturitas.2021.11.011. Epub 2021 Nov 30.
Cervical cancer is frequently diagnosed in older women, but few studies have focused on cervical cancer in this specific population. The objectives of this study were to provide an overview of the demographic profile and therapeutic care of women with cervical cancer, and to identify whether age is a prognostic factor.
Retrospective population-based study from a gynecological cancer registry in a French Regional University Hospital and Comprehensive Cancer Center. 292 women diagnosed with cervical cancer between January 1, 2005, and December 31, 2015, were included. They were classified into younger women (YW), that is, under 70 years of age (N = 228), and older women (OW), that is, aged 70 years or more (N = 64).
The primary outcome was overall survival (OS). Cox proportional hazards models were developed to assess the impact of age on OS.
Compared with YW, larger proportions of OW had comorbidities (14% vs 7% with a score ≥ 2 on the Charlson Comorbidity Index, P <0.001) and more advanced tumors (37.3% vs 19.7% with FIGO IV, P <0.001); the OW group had a lower treatment rate (81.3% vs 95.6%, P <0.001), and a smaller proportion had undergone surgery (37.5% vs 81.7%, P<.001) but a larger proportion had radiotherapy (67.2% vs 49.6%, P = .01). One-year, 5-year and 10-year OS rates were: 91.6%, 74.1% and 63.9% for YW, and 69.9%, 36.4% and 12.3% for OW, respectively (P <0.001). The hazard ratio for death was twice as high in OW compared with YW with cervical cancer (HR = 2.19 [1.41 - 3.40], P <0.001), independently of FIGO stage, histology, and comorbidities.
The prognosis for cervical cancer depends on age. Screening with the G8 tool followed by a comprehensive geriatric assessment could lead to more suitable treatment being offered to older patients.
宫颈癌常发生于老年女性，但针对这一特定人群的宫颈癌研究较少。本研究旨在概述宫颈癌患者的人口统计学特征和治疗情况，并确定年龄是否为预后因素。
这是一项来自法国地区大学医院和综合癌症中心妇科癌症登记处的回顾性基于人群的研究。共纳入了 292 例于 2005 年 1 月 1 日至 2015 年 12 月 31 日期间诊断为宫颈癌的女性，她们被分为年轻女性（YW）和老年女性（OW）。年轻女性组（YW）指年龄小于 70 岁（N=228），老年女性组（OW）指年龄 70 岁或以上（N=64）。
主要结局为总生存期（OS）。采用 Cox 比例风险模型评估年龄对 OS 的影响。
与 YW 相比，OW 组中合并症更多（Charlson 合并症指数评分≥2 的比例为 14%比 7%，P＜0.001），肿瘤分期更晚（FIGO 分期 IV 期的比例为 37.3%比 19.7%，P＜0.001）；OW 组的治疗率更低（81.3%比 95.6%，P＜0.001），手术比例更小（37.5%比 81.7%，P＜0.001），但放疗比例更高（67.2%比 49.6%，P=0.01）。YW 和 OW 的 1 年、5 年和 10 年 OS 率分别为：91.6%、74.1%和 63.9%和 69.9%、36.4%和 12.3%（P＜0.001）。与 YW 相比，OW 的死亡风险是其 2.19 倍（HR=2.19[1.41-3.40]，P＜0.001），这与 FIGO 分期、组织学和合并症无关。
宫颈癌的预后取决于年龄。采用 G8 工具进行筛查并结合全面老年评估，可为老年患者提供更适宜的治疗。
