Advanced age is a significant determinant of poor prognosis in patients treated with surgery plus postoperative radiotherapy for endometrial cancer.
OBJECTIVE
A review was conducted in which the effect of age on survival was assessed in a population of endometrial cancer patients treated with surgery and adjuvant radiation therapy in our institution.


METHODS
From 1988 to 2008, 111 endometrial cancer patients underwent total abdominal hysterectomy and adjuvant whole pelvic radiation therapy (RT). After surgery, for patients with low or intermediate risk without lymph node metastasis, no postoperative adjuvant therapy was performed. For patients with high risk or positive cytology from the abdominal cavity, postoperative radiation therapy was performed. A total dose of 50-50.4 Gy of RT was delivered sequentially. Forty-four patients (44%) were given chemotherapy consisting of epirubicin/cisplatin/carboplatin or paclitaxel/carboplatin. Univariate and multivariate analyses were performed to identify significant prognostic clinicopathological factors.


RESULTS
With a median follow-up time of 59.2 months, the 5-year overall survival was 74% for those 60 years or older versus 90% for those younger than 60 years (P = 0.044). For disease-free survival, it was 65% for those 60 years or older, versus 85% for those younger than 60 years (P = 0.013). On multivariate analysis, poor disease-free survival was associated with age > or = 60 years (P = 0.035).


CONCLUSIONS
Older patients (age > or = 60 years) with endometrial cancer had significantly lower overall survival and disease-free survival following postoperative RT independent of other prognostic factors and/or treatment technique.
Okuma
Kae
K
Department of Radiology, University of Tokyo Hospital, Hongo, Tokyo, Japan.
Yamashita
Hideomi
H
Kawana
Kei
K
Nakagawa
Shunsuke
S
Oda
Katsutoshi
K
Nakagawa
Keiichi
K
D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D017239:Paclitaxel / Q000627:therapeutic use; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome
D017239:Paclitaxel; D002945:Cisplatin