title: Patterns of Care and Outcome of Elderly Women Diagnosed With Cervical Cancer in the Developing World.
abstract: Scarce data exist about the impact of age in cervical cancer (CC) patients in the developing world. The objective of the current study was to examine the patterns of care and outcome of elderly patients treated in a developing country. Medical records of patients treated from 2006-2009 at the Brazilian National Cancer Institute were reviewed. Patients were divided between women 70 years or older and women younger than 70 years. The χ tests were used and odds ratios were calculated. Survival was examined using the Kaplan-Meier method. Single and multivariate Cox proportional hazards modeling were used. A total of 1482 patients were analyzed: 1339 patients younger than 70 years and 143 patients 70 years or older. A marked difference in treatment was noted, even after stratifying by disease stage. Only 21% of the older patients underwent surgical treatment compared with 27.6% of the younger. After adjusting for confounding variables, the hazard ratio for death from CC in the elderly was 1.05 (95% confidence interval, 0.81-1.36; P = 0.11). These results corroborate previous data from developed countries: elderly patients have more advanced disease at diagnosis, and age is an important factor in the allocation of treatment for patients with CC. Worse outcome seemed to be mainly the result of more advanced stage and treatment allocation rather than age itself.
authors.affiliation: *National Cancer Institute, Rio de Janeiro; †EVA, Brazilian Group of Gynecologic Oncology; and ‡University of Itauna, Minas Gerais, Brazil.
authors.forename: Angelica
authors.initials: A
authors.lastname: Nogueira-Rodrigues
authors.forename: Andreia Cristina
authors.initials: AC
authors.lastname: de Melo
authors.forename: Alvaro Henrique Ingles
authors.initials: AH
authors.lastname: Garces
authors.forename: Eduardo
authors.initials: E
authors.lastname: Paulino
authors.forename: Flavia Vieira Guerra
authors.initials: FV
authors.lastname: Alves
authors.forename: Mariana do Nascimento
authors.initials: Mdo N
authors.lastname: Vilaça
authors.forename: Laisa Gabrielle
authors.initials: LG
authors.lastname: Silva
authors.forename: Cristiane Alves
authors.initials: CA
authors.lastname: Gonçalves
authors.forename: Juliana Chaves
authors.initials: JC
authors.lastname: Fabrini
authors.forename: Anderson Thiago Vieira
authors.initials: AT
authors.lastname: Carneiro
authors.forename: Luiz Claudio Santos
authors.initials: LC
authors.lastname: Thuler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002277:Carcinoma / Q000401:mortality / Q000628:therapy*; D003906:Developing Countries / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000628:therapy*; D055815:Young Adult