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Article Dans Une Revue EJSO - European Journal of Surgical Oncology Année : 2023

Endometrial cancer of the very elderly: Management and survival in the Francogyn population

Yohann Dabi
Yohan Kerbage

Résumé

Introduction - We aimed to describe management and survival of patients with endometrial cancer (EC) ≥80 years to identify poor prognosis criteria. Methods - We collected clinical, histologic, surgical and follow-up data for patients with EC ≥ 80 years included in a multicenter French cohort (FRANCOGYN) who underwent primary surgical treatment from 1999 to 2019. The outcomes were overall survival (OS) and disease-free survival (DFS). We performed a descriptive analysis then a survival time analysis and comparison using the Kaplan Meier method and log-rank test. Results - Of the 1647 patients with EC who received treatment during the study period, 184 (11.17%) were ≥80 years. The mean age was 84 years (±3.34). Thirty-three patients (25.4%) died during the follow-up period and 26 relapsed (18.4%). Forty-nine patients were lost to follow-up (27.37%). The median follow-up time was 15.3 months (4.9-28.8). The median OS and DFS was 16.4 months (6.3-24.9) and 13.6 months (4.5-26.6), respectively. Eighty-three patients received adjuvant therapy (45.11%), out of 95 who had a formal or relative indication. Four patients received adjuvant chemotherapy (2.6%), out of 61 who had a formal or relative indication. Inappropriate or underuse of chemotherapy was significantly associated with a lower median OS of 12.6 months [3.73-24] versus 17.3 months [7.93-41.77] when performed appropriately (HR = 4.14, CI 95% [1.62-10.56]), and a lower median DFS of 10.83 months [3.73-24] versus 17.3 months [7.93-28.5] (HR = 9.04, CI 95% [2.04-40.12]). Conclusion - Our results suggest that very elderly patients with EC should receive adjuvant chemotherapy according to the standard care guidelines.

Domaines

Cancer
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Licence : CC BY NC - Paternité - Pas d'utilisation commerciale
Licence : CC BY NC - Paternité - Pas d'utilisation commerciale

Dates et versions

hal-04239478 , version 1 (03-11-2023)

Licence

Paternité - Pas d'utilisation commerciale

Identifiants

Citer

Flore-Anne Martin, Ludivine Dion, Krystel Nyangoh Timoh, Pierre François Dupré, Henri Azaïs, et al.. Endometrial cancer of the very elderly: Management and survival in the Francogyn population. EJSO - European Journal of Surgical Oncology, 2023, 49 (5), pp.1023-1030. ⟨10.1016/j.ejso.2023.01.008⟩. ⟨hal-04239478⟩
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