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Patterns of Care and Outcome of Elderly Women Diagnosed With Cervical Cancer in the Developing World
  1. Angelica Nogueira-Rodrigues, MD, PhD*,,
  2. Andreia Cristina de Melo, MD, PhD*,,
  3. Alvaro Henrique Ingles Garces, MD*,
  4. Eduardo Paulino, MD*,,
  5. Flavia Vieira Guerra Alves, MSc*,
  6. Mariana do Nascimento Vilaça, MD,
  7. Laisa Gabrielle Silva, MD,
  8. Cristiane Alves Gonçalves, MD,
  9. Juliana Chaves Fabrini, MD,
  10. Anderson Thiago Vieira Carneiro, MD and
  11. Luiz Claudio Santos Thuler, MD*
  1. *National Cancer Institute, Rio de Janeiro;
  2. EVA, Brazilian Group of Gynecologic Oncology; and
  3. University of Itauna, Minas Gerais, Brazil.
  1. Address correspondence and reprint requests to Angelica Nogueira-Rodrigues, MD, PhD, Federal University, Minas Gerais Avenida Alfredo Balena, 110 - 2o andar, Belo Horizonte, Minas Gerais, Brazil. E-mail: angelica.onco@uol.com.br.

Abstract

Abstract Scarce data exist about the impact of age in cervical cancer (CC) patients in the developing world. The objective of the current study was to examine the patterns of care and outcome of elderly patients treated in a developing country. Medical records of patients treated from 2006–2009 at the Brazilian National Cancer Institute were reviewed. Patients were divided between women 70 years or older and women younger than 70 years. The χ2 tests were used and odds ratios were calculated. Survival was examined using the Kaplan-Meier method. Single and multivariate Cox proportional hazards modeling were used. A total of 1482 patients were analyzed: 1339 patients younger than 70 years and 143 patients 70 years or older. A marked difference in treatment was noted, even after stratifying by disease stage. Only 21% of the older patients underwent surgical treatment compared with 27.6% of the younger. After adjusting for confounding variables, the hazard ratio for death from CC in the elderly was 1.05 (95% confidence interval, 0.81–1.36; P = 0.11). These results corroborate previous data from developed countries: elderly patients have more advanced disease at diagnosis, and age is an important factor in the allocation of treatment for patients with CC. Worse outcome seemed to be mainly the result of more advanced stage and treatment allocation rather than age itself.

  • Cervical cancer
  • Elderly
  • Treatment
  • Patterns of care
  • Survival
  • Developing world

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Footnotes

  • The authors declare no conflicts of interest.

  • Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

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