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Is Older Age a Real Adverse Prognostic Factor in Women With Early-Stage Endometrial Carcinoma? A Matched Analysis
  1. Laura Haley, BS*,
  2. Charlotte Burmeister, MS,
  3. Thomas Buekers, MD and
  4. Mohamed A. Elshaikh, MD*
  1. *Department of Radiation Oncology,
  2. Department of Public Health Science, and
  3. Division of Gynecologic Oncology, Department of Women’s Health Services, Henry Ford Hospital, Detroit, MI.
  1. Address correspondence and reprint requests to Mohamed A. Elshaikh, MD, Department of Radiation Oncology Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202. E-mail: melshai1@hfhs.org.

Abstract

Objectives The aim of this study was to evaluate if older age alone negatively impacts survival endpoints in women with early-stage uterine endometrioid carcinoma (EC), or its reported prognostic impact is due to an interaction with other well-known adverse factors using matched-analysis methodology.

Methods We identified 1254 patients with International Federation of Gynecology and Obstetrics stage I–II EC who underwent hysterectomy at our institution. We created 2 matched groups based on International Federation of Gynecology and Obstetrics stage, tumor grade, lymph node dissection status, and the type of adjuvant management. Recurrence-free (RFS), disease-specific (DSS) and overall survival (OS) were calculated.

Results A total 297 women 70 years or older were matched with 297 women younger than 70 years. The 2 groups were well balanced except for age and higher body mass index in younger patients. There were no significant difference between older and younger patients in regard to 5-year RFS (85% vs 87%; P = 0.52) or DSS (93% for both groups with P = 0.77). Five-year OS was shorter in older patients (76% vs 88% with P < 0.001). On multivariate analysis for RFS and DSS, high tumor grade and the presence of lymphovascular space invasion (LVSI) were the only 2 predictors of shorter RFS and DSS (P = 0.01 and P = 0.02, and P = 0.01 and P = 0.01, respectively). Tumor grade and LVSI also were predictors of shorter OS.

Conclusions Our study suggests that when older patients with EC are matched with younger patients based on tumor stage, grade, and adjuvant management the prognostic impact of old age disappears. High tumor grade and LVSI remained as independent predictors of survival endpoints.

  • Early stage
  • Old age
  • Prognosis
  • Recurrence
  • Survival
  • Uterine carcinoma

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Footnotes

  • This study was presented as a poster at the 47th Annual meeting on Women’s Cancer, Society of Gynecologic Oncology; San Diego, CA; March 2016.

  • The authors declare no conflicts of interest.

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