Pathologic findings and outcomes for octogenarians presenting with uterine malignancy.
OBJECTIVE
We evaluated prognostic, demographic and outcome data for patients>80 years old with uterine cancer (UC).


METHODS
A retrospective review of clinical records was performed. Categorical data were compared using Fisher's exact test and Kaplan-Meier for survival data.


RESULTS
Sixty-five patients were identified with a mean age of 84 and BMI 27. Sixty-five percent of patients had medical co-morbidities. Forty-two (65%) were Stage I; 10 (15%) were Stage II; 8 (12%) were Stage III; and 5 (8%) were Stage IV. Stage I patients included those identified via hysterectomy with lymph nodes (LND) (30) or clinical impression (12). Comparing clinically Stage I UC to those with LND, the clinical group was older (86 vs. 83; p=0.01) and tended to have more medical co-morbidity (89% vs. 63%; p=0.14). Two-year overall survival (OS) among unstaged vs. staged patients was 62% vs. 77%; p=0.11. Among staged patients with Stage I UC, 21 (70%) met high intermediate risk (HIR) criteria per GOG 99 and 90% received no adjuvant therapy. Three patients (16%) recurred with 1 (5%) locoregional recurrence. Two-year OS is 77%.


CONCLUSIONS
Elderly patients with UC have features associated with extrauterine spread. Both clinically and surgically staged Stage I patients had excellent OS at 2 years despite no adjuvant therapy. Prevalent medical co-morbidities may impact survival more than recurrence risk. The 23% recurrence rate among HIR patients in GOG 99 was not observed in our data, suggesting that observation for elderly Stage I patients is acceptable.
Moore
Kathleen N
KN
University of Oklahoma Division of Gynecologic Oncology, 920 SL Young Blvd., Oklahoma City, OK 73103, USA. Kathleen-moore@ouhsc.edu
Lanneau
Grainger S
GS
Smith
Chad
C
Lanneau
Marion
M
Walker
Joan L
JL
Gold
Michael A
MA
Scott McMeekin
D
D
D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery