title: Management and Survival of Elderly and Very Elderly Patients with Endometrial Cancer: An Age-Stratified Study of 1228 Women from the FRANCOGYN Group.
abstract: BACKGROUND
  Little data exist about the clinical management and survival of elderly patients with endometrial cancer. This study aimed to evaluate the management of elderly and very elderly patients with endometrial cancer as well as the overall survival (OS) rate, disease-free survival (DFS) rate, and cancer-specific survival (CSS) rate in a multicenter cohort.
  
  
  METHODS
  Data from 1228 patients with endometrial cancer who received primary treatment between January 2001 and December 2012 were collected from a multicenter database. Clinical management, DFS, CSS, and OS were analyzed.
  
  
  RESULTS
  Based on the international endometrial cancer risk classification, 36% (212/582) of women age 65 years or younger, 42% (220/526) of women ages 65-80 years, and 48% (58/120) of women older than 80 years showed high-risk endometrial cancer (p < 0.001). Pelvic lymphadenectomy was performed for 85% (230/271) of the women age 65 years or younger and 46% (33/71) of the women older than 80 years (p < 0.001). Radiotherapy was performed for 27% (33/120) of the very elderly and 40% (233/582) of the young patients (p = 0.009). The 3-year CSS rates were 95% (95% confidence interval [CI], 93-97%) for the women age 65 years or younger, 90% (95% CI, 87-94%) for the women ages 65-80 years, and 82% (95% CI, 73-93%) for the women older than 80 years (p < 0.001).
  
  
  CONCLUSIONS
  The elderly and very elderly patients with endometrial cancer showed poorer prognosis than young patients. The significant lower CSS rate for the elderly patients could have be due to both the higher rate of high-risk endometrial cancer and undertreatment. Specific guidelines for the management of elderly and very elderly patients with endometrial cancer are needed to improve their prognosis.
authors.affiliation: CHU de Rennes, Service de Gynécologie, Hopital sud, Rennes, France.|Université de Rennes 1, Rennes, France.|Oncogenesis, Stress and Signaling, CRLCC Eugène Marquis, Rennes, France.
authors.forename: Clothilde
authors.initials: C
authors.lastname: Poupon
authors.affiliation: Oncogenesis, Stress and Signaling, CRLCC Eugène Marquis, Rennes, France.|Department of Gynaecology and Obstetrics, Institut Universitaire de Cancérologie (IUC), Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Paris, France.|INSERM UMR_S_707, EpidemiologyInformation SystemsModeling, University Pierre and Marie Curie, Paris 6, Paris, France.
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bendifallah
authors.affiliation: Department of Obstetrics and Gynaecology, Centre hospitalier régional universitaire de Tours, Hôpital Bretonneau, Tours, France.
authors.forename: Lobna
authors.initials: L
authors.lastname: Ouldamer
authors.affiliation: Department of Gynaecology and Obstetrics, Institut Universitaire de Cancérologie (IUC), Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Paris, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Canlorbe
authors.affiliation: Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Raimond
authors.affiliation: Centre de Lutte Contre le Cancer Georges François Leclerc, Dijon, France.
authors.forename: Nina
authors.initials: N
authors.lastname: Hudry
authors.affiliation: Centre de Lutte Contre le Cancer Georges François Leclerc, Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Graesslin
authors.affiliation: Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Touboul
authors.affiliation: Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire, Lille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Collinet
authors.affiliation: Department of Gynaecology and Obstetrics, Jean Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris 13, Villetaneuse, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bricou
authors.affiliation: Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal, Poissy, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Huchon
authors.affiliation: Department of Gynaecology and Obstetrics, Institut Universitaire de Cancérologie (IUC), Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Paris, France.|INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.affiliation: Department of Gynaecology and Obstetrics, Institut Universitaire de Cancérologie (IUC), Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Paris, France.|INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, Paris, France.
authors.forename: Marcos
authors.initials: M
authors.lastname: Ballester
authors.affiliation: CHU de Rennes, Service de Gynécologie, Hopital sud, Rennes, France.|Université de Rennes 1, Rennes, France.|Oncogenesis, Stress and Signaling, CRLCC Eugène Marquis, Rennes, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Levêque
authors.affiliation: CHU de Rennes, Service de Gynécologie, Hopital sud, Rennes, France. vincent.lavoue@chu-rennes.fr.|Université de Rennes 1, Rennes, France. vincent.lavoue@chu-rennes.fr.|Oncogenesis, Stress and Signaling, CRLCC Eugène Marquis, Rennes, France. vincent.lavoue@chu-rennes.fr.|Service de Gynécologie, CHU de Rennes, Rennes, France. vincent.lavoue@chu-rennes.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lavoue
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018284:Cystadenocarcinoma, Serous / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate