The importance of age as a prognostic factor in corpus cancer

Abstract

15005 Background: To determine the prognostic factors that influence the survival of younger women diagnosed with uterine cancers. Methods: Patients with a diagnosis of uterine cancer were isolated from the Surveillance, Epidemiology, and End Results (SEER) cancer database from 1988–2001 and demographic and clinico-pathologic data were collected. Patients in the database were stratified by age at diagnosis into two age groups: ≤40and >40 years old. Disease specific survival was calculated using Kaplan-Meier estimates. Results: Of the 51,471 women diagnosed with uterine cancer in the study period, 2076 patients were ≤40 and 49,395 were >40 years old. The mean age in the younger group was 35.6 and that of the older group was 65.2. The overall distribution by stage was Stage I-76%, II-8%, III-7% and IV-9%. Younger patients were more likely to be non-white (30% vs 18%, p < 0.05), have earlier stage disease (79% vs 75%, p < 0.05), grade 1 lesions (48% vs 36%, p <0.05) and sarcomas (16% vs 8%) compared to their older counterparts. The overall disease specific 5-year survival demonstrated that younger patients (≤40 years old) had a significantly improved survival prognosis in comparison to older women (93% versus 86%; p < 0.0001). This survival difference remains significant after adjusting for stage, race, surgical treatment, and radiation treatment. Subgroup analysis revealed no statistical difference in outcome between the two age groups for patients with clear cell histology. There also was no statistical significance in survival for patients with grade 2 or 3 lesions and advanced stage disease. Conclusions: Our large population based study demonstrates that younger patients (≤40) have an overall survival advantage compared to women >40 years. This difference remains significant when adjusted for stage, race, surgical treatment, and radiation treatment. Women with clear cell cancers of the uterus appear to have a poor prognosis independent of age. No significant financial relationships to disclose.