IMR Press / EJGO / Volume 39 / Issue 3 / DOI: 10.12892/ejgo3923.2018
Open Access Original Research
Impact of age on the quality of care in endometrial cancer: a retrospective study of 145 patients
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1 Département d'obstétrique et gynécologie, Hôpital Nord, CHU de Saint-étienne, Saint-Priest-en-Jarez, France
2 Service d'oncologie médicale, CHU de Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
3 EA 3065, groupe de recherche sur la thrombose, Université Jean-Monnet, Saint-étienne cedex, France
Eur. J. Gynaecol. Oncol. 2018 , 39(3), 408–414; https://doi.org/10.12892/ejgo3923.2018
Published: 10 June 2018
Abstract

Objectives: Endometrial cancer is the fourth most common cancer and affects mostly the elderly. Advanced age is a poor prognostic factor but reasons are numerous and controversial. The objective of this study was to characterize the effect of age on endometrial cancer patients medical care. Materials and Methods: It was a descriptive and comparative study of a retrospective cohort of 145 patients having received care for endometrial cancer during ten years in the Gynecological Department of Saint-Etienne Hospital. The 145 patients studied were subdivided into three groups according to their age at diagnosis: < 70 (group 1), 70-79 (group 2), and > 80 (group 3). The data collected were: clinical characteristics; preoperative, operating and pathological data, and postoperative care. For each patient, the authors evaluated compliance to patient management guidelines. Results: Postmenopausal bleeding was the most common reason of first consultation and incidental diagnoses were more frequent in group 2 (13.8%). Concerning FIGO staging, there was an over-representation of Stages III and IV in group 1, while the distribution was more in favor of Stages I and II for older patients groups. No para-aortic lymphadenectomy was performed in patients from group 3 despite seven theoretical indications. This non-compliance to guidelines was detected in two-thirds of patients in group 3. Conclusion: Elderly patients from the present cohort showed less aggressive and advanced tumors compared to younger patients. Yet, they did not receive optimal surgical and adjuvant therapy according to guidelines. A multidisciplinary evaluation using standardized assessment is needed in order to help physicians in the decision-making process.
Keywords
Elderly patients
Gynecologic oncology
Endometrial cancer
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