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Original Research

Open Access

Overall and cancer specific survival following radical or adjuvant (chemo)radiotherapy in a retrospective cohort of elderly patients with endometrial cancer

  • Kathryn Graham1,*,
  • Cicely Cunningham1
  • Katherine Fair1
  • Philip McLoone2
  • Marina Chitoni1
  • Rosie Harrand1
  • Ashleigh Kerr1
  • Nick Reed1
  • Azmat Sadozye1

1Beatson West of Scotland Cancer Centre, NHS Greater Glasgow and Clyde, G12 0YN Glasgow, UK

2Institute of Health and Wellbeing, University of Glasgow, G12 8RZ Glasgow, UK

DOI: 10.22514/ejgo.2022.039 Vol.43,Issue 5,October 2022 pp.9-17

Submitted: 30 May 2022 Accepted: 08 August 2022

Published: 15 October 2022

*Corresponding Author(s): Kathryn Graham E-mail: kathryn.graham@ggc.scot.nhs.uk

Abstract

To report the overall survival and cancer specific survival outcomes of elderly women aged ≥70 years who received radical or adjuvant (chemo)radiotherapy for endometrial cancer, we conducted a retrospective review of 93 patients from the West of Scotland Cancer Network (WoSCAN) who received pelvic (+/− para-aortic) radiotherapy over a 5-year period (January 2011 to December 2015, inclusive). Association of treatment type and other variables with overall survival (OS) and cancer specific survival (CSS) were analysed using log rank tests and Cox proportional hazards models. Median age of the study population was 74 years (range 70–90 years); over 50% of patients were aged ≥75 years, and over 25% were ≥80 years. The majority of patients had endometrioid endometrial cancer (75.3%), and 24.7% had a high-risk histological subtype. Stage distribution was as follows: I/II (40.9%); III/IV (41.9%); recurrent disease (17.2%). Radiotherapy was predominantly delivered in the adjuvant setting (61.3%); intent was primary (22.6%) or salvage (16.1%) in the remaining patients. Chemotherapy was administered to almost 50% of the cohort, mainly in conjunction with adjuvant radiotherapy. After median follow up of 96 months, 5-year OS and CSS were 50.5%and CSS 59.3% for the entire series, 57.9% and 62.8% in the adjuvant group, 23.8% and 35.7% in the primary group, and 60.0% and 80.0% in the salvage group, respectively. Age ≥80 years and primary radiotherapy were statistically significant predictors of poorer survival, adjusting for pathology, stage and grade (hazard ratio (HR) 2.06, 95%Confidence Interval (CI) (1.11–3.80), p = 0.021; and HR 2.42 (CI 1.28–4.57), p = 0.006 respectively). In summary, poorer OS was associated with use of (chemo)radiotherapy as primary treatment of endometrial cancer and/or in women aged ≥80 years, suggesting that careful risk/benefit analysis is required in these two groups.


Keywords

Endometrial cancer; Elderly; Radiotherapy; Chemotherapy; Chemoradiotherapy; Real-world; Surgery


Cite and Share

Kathryn Graham,Cicely Cunningham,Katherine Fair,Philip McLoone,Marina Chitoni,Rosie Harrand,Ashleigh Kerr,Nick Reed,Azmat Sadozye. Overall and cancer specific survival following radical or adjuvant (chemo)radiotherapy in a retrospective cohort of elderly patients with endometrial cancer. European Journal of Gynaecological Oncology. 2022. 43(5);9-17.

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