Pathologic findings and outcomes for octogenarians presenting with uterine malignancy

Abstract

Objective. We evaluated prognostic, demographic and outcome data for patients > 80 years old with uterine cancer (UC). Methods. A retrospective review of clinical records was performed. Categorical data were compared using Fisher's exact test and Kaplan-Meier for survival data. Results. Sixty-five patients were identified with a mean age of 84 and BMI 27. Sixty-five percent of patients had medical co-morbidities. Forty-two (65%) were Stage I; 10 (15%) were Stage II; 8 (12%) were Stage III; and 5 (8%) were Stage IV. Stage I patients included those identified via hysterectomy with lymph nodes (LND) (30) or clinical impression (12). Comparing clinically Stage I UC to those with LND, the clinical group was older (86 vs. 83; p = 0.01) and tended to have more medical co-morbidity (89% vs. 63%; p = 0.14). Two-year overall survival (OS) among unstaged vs. staged patients was 62% vs. 77%; p = 0.11. Among staged patients with Stage I UC, 21 (70%) met high intermediate risk (HIR) criteria per GOG 99 and 90% received no adjuvant therapy. Three patients (16%) recurred with 1 (5%) locoregional recurrence. Two-year OS is 77%. Conclusion. Elderly patients with UC have features associated with extrauterine spread. Both clinically and surgically staged Stage I patients had excellent OS at 2 years despite no adjuvant therapy. Prevalent medical co-morbidities may impact survival more than recurrence risk. The 23% recurrence rate among HIR patients in GOG 99 was not observed in our data, suggesting that observation for elderly Stage I patients is acceptable.