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Publications

Journal Article Ahead of print

PubMed: 41043284 DOI: 10.1016/j.maturitas.2025.108741

Are older women with early-stage endometrial cancer undertreated and more likely to die from their cancer?

Maturitas 202:108741

Authors: Jeremy Barben, Ariane Mamguem Kamga, Adrien Guilloteau, Valerie Quipourt, Leila Bengrine-Lefevre, Tienhan Sandrine Dabakuyo-Yonli

Affiliations

  • Université Bourgogne Europe, CHU Dijon Bourgogne, Gériatrie Ambulatoire, 21000 Dijon, France; Geriatric Oncology Coordination Unit in Burgundy, 21000 Dijon, France; Université Bourgogne Europe, Centre Georges-François Leclerc, Unicancer, Côte d'Or Breast and Gynecological Cancer Registry, INSERM U1231 CTM, Equipe Epi2THM, 21000 Dijon, France.
  • Université Bourgogne Europe, Centre Georges-François Leclerc, Unicancer, Côte d'Or Breast and Gynecological Cancer Registry, INSERM U1231 CTM, Equipe Epi2THM, 21000 Dijon, France.
  • Université Bourgogne Europe, CHU Dijon Bourgogne, Registre des hémopathies malignes de Côte d'Or, INSERM U1231 CTM, Equipe Epi2THM, 21000 Dijon, France.
  • Université Bourgogne Europe, CHU Dijon Bourgogne, Gériatrie Ambulatoire, 21000 Dijon, France; Geriatric Oncology Coordination Unit in Burgundy, 21000 Dijon, France.
  • Geriatric Oncology Coordination Unit in Burgundy, 21000 Dijon, France; Université Bourgogne Europe, Centre Georges-François Leclerc, Unicancer, Department of Medical Oncology, 21000 Dijon, France.

Abstract

UNLABELLED

Endometrial cancer is the most common gynecological malignancy in developed countries, mainly affecting older women and raising concerns about potential under-treatment. This study aimed to describe treatment patterns and assess net survival in older women with early-stage endometrial cancer.

STUDY DESIGN

This French retrospective observational study used a gynecological cancer registry. Patients diagnosed with FIGO I-II endometrial cancer from 1998 to 2018 were included and stratified by age (a younger group, under 70 years, and an older group, aged 70 years or more). A multiple penalized splines model was used.

RESULTS

A total of 828 patients were included: 448 women aged under 70 and 380 aged 70 or more. Older patients belonged to higher-risk groups as defined by ESGO-ESTRO-ESP 2021 criteria (p < 0.001) and had a lower rate of low-grade endometrioid carcinoma (75.1 % vs. 85.7 %, p = 0.003). Treatment patterns did not differ by age; surgery plus adjuvant therapy remained the main treatment (69.7 % vs. 70.8 % in the older and younger groups, respectively, p = 0.87). 5-year net survival was 95.0 % (95 % CI: 92.6-97.6) for younger and 84.3 % (95 % CI: 78.8-90.3) for older women. The univariate hazard ratio for death in older vs. younger women was 2.38 (95 % CI: 1.19-4.74; p = 0.02). Multivariate analysis attenuated age's effect: hazard ratio 1.38 (95 % CI: 0.97-3.31; p = 0.06). Charlson Comorbidity Index and non-low-grade endometrioid histology predicted poorer survival. Diagnosis period was not associated with survival.

CONCLUSION

No significant difference in treatment was found according to age. Although age was associated with 5-year net survival in univariate analysis, this association was no longer observed after adjusting for diagnosis period, comorbidities, and histology.

MeSH

Comorbidity, Neoplasms, Aged, Climacteric, Histology, Therapeutics, Menopause, Geriatrics, Endometrial Neoplasms