Assessment of treatment factors and clinical outcomes in cervical cancer in older women compared to women under 65 years old. Issue 5 (September 2018)

• Record Type: Journal Article
• Authors: Diver, Elisabeth J.; Hinchcliff, Emily M.; Gockley, Allison A.; Melamed, Alexander; Contrino, Leah; Feldman, Sarah; Growdon, Whitfield B.
• Is Part Of: Journal of geriatric oncology. Volume 9:Issue 5(2018)
• Page Start: 516
• Page End: 519
• Publication Date: 2018-09
• Subjects: Cervical carcinoma -- Elderly -- Radical hysterectomy -- Chemoradiation; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2018.02.004
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Objective: This study aims to understand the treatment patterns and clinical outcomes of older women with cervical cancer compared to younger women. Methods: Women undergoing care for cervical cancer between 2000 and 2013 at two academic institutions were identified. The cohort of older patients was defined as >65 years old at diagnosis. Patient charts were retrospectively reviewed, and clinical variables were extracted. Fisher's exact tests, logistic regression, and Kaplan-Meier analyses were performed. Results: From 2000 to 2013 1119 women with cervical cancer were identified. Of these, 191 (17.0%) were >65 years old at the time of diagnosis. Older women were more likely to present with higher stage disease (p < 0.001). Controlling for stage, older women were less likely to undergo surgery during their treatment course (38% versus 70%, p < 0.001) and more likely to undergo radiation (77% versus 52%, p < 0.001), but no more likely to receive chemotherapy (p = 0.34). If they did undergo surgery, older women were less likely to have a pelvic lymph node dissection performed (41% versus 61%, p = 0.04), though the rate of positive pelvic lymph nodes was not different (p = 0.80). Overall survival was decreased in the older cohort (p < 0.001). A multivariate model identified age > 65 (HR 1.76, 95%CI 1.30–2.40), stage (HR 2.77, 95%CI 2.40–3.21), and ever undergoing surgery (HR 0.60, 95%CI 0.44–0.82) as independently associated with overall survival. Conclusions: Women over age 65 with cervical cancer are less likely to undergo surgical management and were observed to have a decreased overall survival, even when controlling for use of surgery and stage of disease.