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397 Locally advanced cervical cancer in elderly women
  1. Ines Zemni1,2,
  2. Marwa Aloui1,
  3. Nadia Boujelbene2,3,
  4. Saida Sakhri1,
  5. Ines Zidi2,
  6. Mohamed Ali Ayadi1,2 and
  7. Tarek Ben Dhiab1
  1. 1Department of Surgical Oncology, Salah Azaiez Institute, Faculty of Medicine of Tunis, Tunis, Tunisia
  2. 2Laboratory Microorganisms and Active Biomolecules, Sciences Faculty of Tunis, University Tunis El Manar, Tunis, Tunisia
  3. 3Department of Pathology, Salah Azaïz Institute, Faculty of Medicine, Tunis, Tunisia

Abstract

Introduction/Background The incidence of locally advanced cervical cancer is increasing, particularly in older women (≥65ans) and the outcome of cervical cancer related to age is controversial. We conducted a retrospective analysis in patients treated for advanced cervical cancer in order to investigate patient characteristics and prognosis of older patients

Methodology Medical record data of 45 locally advanced cervical cancer patients aged ≥ 65 years treated at Salah Azaiez Institute of Oncology between January 2010 and December 2020 were reviewed. The overall survival rate was estimated using the Kaplan-Meier method. Prognosis-related risk factors were analyzed using univariate analysis

Results The median age at diagnosis was 72.2 years (65–85 years). Among 45 patients, 44 were diagnosed with squamous cell carcinoma (97.8%) and 1 with adenocarcinoma (2.2%). In 25 cases (55.6%), the FIGO stage was ≤ IIB and in 20 cases (44.4%) FIGO stage was ≥ IIIA. The median tumor size at diagnosis was 47mm (10–100mm).

Five-year disease-free survival (DFS) was 67.9%. lymphovascular space involvement (LVSI) (p=0.000) and pelvic lymph node metastases (p=0.000)were prognostic factors that affected disease-free survival. DFS was not significantly different for tumor size (p=0.063), histological grade (p=0.065), parametrial involvement (p=0.113), and FIGO stage (p=0.057).

Five-year overall survival (OS) was 47.1%. Diabetes (p=0.027), Cell type (p=0.019), FIGO stage (p=0.014), surgery (p=0.028), and para-aortic lymph node metastases on MRI (p=0.005) were risk factors of poor prognosis for these patients. Os survival was not significantly different for tumor size, LVSI, and pelvic lymph node metastases.

Conclusion In parallel with the increasing rate of LACC especially in elderly patients, it should be remembered that these women had difficulty in accessing screening tests, late diagnosis, and inadequate treatment regimens due to concomitant diseases, resulting in recurrence in a short time and poor clinical symptoms due to short total survival.

Disclosures No conflict of interest.

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