Faculty Collaboration Database

Cervical carcinoma in the elderly: an analysis of patterns of care and outcome. Cancer 2005 Jan 01;103(1):85-91

Date

11/13/2004

Pubmed ID

15540239

DOI

10.1002/cncr.20751

Scopus ID

2-s2.0-10844288924 (requires institutional sign-in at Scopus site)   83 Citations

Abstract

BACKGROUND: Advanced age often is considered a poor prognostic factor for cervical carcinoma. The authors investigated the patterns of care and treatment outcomes of elderly women with cervical carcinoma.

METHODS: A hospital-based tumor registry was used to identify patients with invasive cervical carcinoma who were treated between 1986 and 2003. Patients were divided into 2 cohorts: women age < 70 years and women age > or = 70 years. Survival was examined using the Kaplan-Meier method. Single and multivariate Cox proportional hazards modeling was used to estimate hazard ratios with 95% confidence intervals (95% CI).

RESULTS: In total, 1582 patients were identified, including 1385 patients age < 70 years and 197 patients age > or = 70 years. The elderly patients presented with more advanced stage tumors at diagnosis (P <0.0001) and were more likely to have nonsquamous neoplasms (P=0.002). A marked difference in treatment was noted for the elderly cohort, even after stratifying by disease stage. Only 16% of the older patients underwent surgical treatment compared with 54% of the younger patients (P <0.0001). Elderly women were 9 times more likely to receive no treatment (P <0.0001). In a multivariate model of known prognostic factors, the hazard ratio for death from any cause in women age > 70 years was 2.1 (95% CI, 1.5-3.0). The hazard ratio for death from cervical carcinoma in the elderly women was 1.6 (95% CI, 1.1-2.5).

CONCLUSIONS: Age is an important factor in the allocation of treatment and survival for patients with cervical carcinoma. Elderly women with cervical carcinoma are more likely to receive primary radiotherapy, to forego treatment, and to die from their disease.

Author List

Wright JD, Gibb RK, Geevarghese S, Powell MA, Herzog TJ, Mutch DG, Grigsby PW, Gao F, Trinkaus KM, Rader JS

Author

Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Aged, 80 and over
Carcinoma
Cohort Studies
Female
Humans
Middle Aged
Practice Patterns, Physicians'
Prognosis
Registries
Survival Analysis
Treatment Outcome
Uterine Cervical Neoplasms