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  • 2022-RA-825-ESGO The impact of age on prognosis in women with endometrial cancer: a pooled analysis of the PORTEC-1, -2 and -3 randomised trials

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Endometrial cancer
2022-RA-825-ESGO The impact of age on prognosis in women with endometrial cancer: a pooled analysis of the PORTEC-1, -2 and -3 randomised trials
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  1. Famke Charlotte Wakkerman1,
  2. Stephanie M De Boer1,
  3. Melanie E Powell2,
  4. Alexandra Leary3,
  5. Anthony Fyles4,
  6. Linda R Mileshkin5,
  7. Naveena Singh6,
  8. Remi A Nout7,
  9. Ina M Jürgenliemk-Schulz8,
  10. Jan J Jobsen9,
  11. Ludy CHW Lutgens10,
  12. Elsbieta M van der Steen-Banasik11,
  13. Jan-Willem M Mens7,
  14. Annerie Slot12,
  15. Hans W Nijman13,
  16. Vincent THBM Smit14,
  17. Tjalling Bosse14,
  18. Carien L Creutzberg1 and
  19. Nanda Horeweg1
  1. 1Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
  2. 2Department of Clinical Oncology, Barts Health NHS Trust, London, UK
  3. 3Department of Medical Oncology, Gustave Roussy, Villejuif, France
  4. 4Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
  5. 5Department of Medical Oncology, Peter MacCallum Cancer Center, Melbourne, Australia
  6. 6Department of Pathology, Barts Health NHS Trust, London, UK
  7. 7Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
  8. 8Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands
  9. 9Department of Radiotherapy, Medisch Spectrum Twente, Enschede, Netherlands
  10. 10Maastricht Radiation Oncology Clinic, Maastricht, Netherlands
  11. 11Radiotherapiegroep, Arnhem, Netherlands
  12. 12Radiotherapeutic Institute Friesland, Leeuwarden, Netherlands
  13. 13Department of Gynaecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
  14. 14Department of Pathology, Leiden University Medical Center, Leiden, Netherlands

Abstract

Introduction/Background Numerous studies showed that elderly women with endometrial cancer (EC) have a higher risk of recurrence and cancer-related death. It is unclear whether ageing is a risk factor by itself, or whether other risk factors become increasingly common at older age. We addressed to this using the large PORTEC collection of molecularly classified EC with long-term follow-up data.

Methodology Data of 1801 women participating in the randomised PORTEC trials were pooled and analysed. PORTEC-1 included 714 women with intermediate-risk EC, PORTEC-2 427 with high-intermediate risk EC, and PORTEC-3 660 with high-risk EC. Overall recurrence-free and EC-specific survival were estimated using Kaplan-Meier’s method. Prognostic value of age (continuous) was determined by multivariable Cox regression analyses with correction for all significant risk factors identified by univariable analyses.

Abstract 2022-RA-825-ESGO Figure 1
Abstract 2022-RA-825-ESGO Figure 1

Clinical outcomes by age of women with endimetrial cancer participanting in the PORTEC-1, -2 and -3 trial

View this table:
Abstract 2022-RA-825-ESGO Table 1

The relation of age with clinicopathological and molecular variable of EC

Results Median follow-up was 12.3 years for PORTEC-1, 10.5 years for PORTEC-2 and 6.1 years for PORTEC-3. Overall recurrence-free and EC-specific survival significantly decreased with age (figure 1). The relation of age with clinicopathological and molecular variables of EC is shown in table 1. Women ≥60 years had significantly less often POLEmut (5.7% vs. 18.2%) and more often p53abn EC (16.1% vs. 7.6%, p<0.0001). In multivariable analysis, age was an independent risk factor for overall recurrence with a hazard ratio (HR) of 1.03 per year (95%CI 1.02–1.05; p<0.0001), corrected for stage, histotype and grade, myometrial invasion, lymphovascular space invasion (LVSI), molecular class and received adjuvant treatment. Likewise, age had independent prognostic value for EC-specific survival with an HR of 1.05 per year (95%CI 1.02–1.07; p<0.0001), corrected for stage, histotype and grade, LVSI and molecular class.

Conclusion The molecular profile of elderly women was less favourable. The risk of recurrence and EC-related death continuously increases with age, especially from 60 years onwards. Our study showed that age is a significant and independent prognostic risk factor.

https://doi.org/10.1136/ijgc-2022-ESGO.246

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