Clinical and prognostic analysis of elderly patients with cervical cancer / 中华老年医学杂志

ABSTRACT

Objective To explore the prognosis and risk factors for cervical cancer in elderly patients. Methods Clinical data of 337 elderly patients (≥ 65 years old )admitted into Zhejiang Cancer Hospital from June 2008 to June 2013 were retrospectively analyzed.Clinical data and the follow-up information were collected. The correlation of prognosis with age ,performance status score , International Federation of Gynecology and Obstetrics (FIGO )staging ,tumor size ,pathological type , treatment and comorbidities were analyzed. Results Among 337 elderly patients ,the 5-year overall survival(OS )rates for patients with stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 81.8% ,62.3% ,53.5% and 0.0% , respectively (χ2=63.414 ,P=0.000) ;local recurrence rate was 33.5% ;the 5-year OS rate of patients with and without comorbidities were 54.0% and 70.0% ,respectively(χ2=8.907 ,P=0.003).Among 119 cervical cancer patients with stage ⅠA-ⅡA ,5-year OS for surgery group and radiotherapy group were 83.5% and 55.0% ,respectively(χ2=13.161 ,P=0.000).Among 218 advanced cervical cancer patients ,the 5 year OS for chemoradiotherapy and radiotherapy groups were 69.7% and 51.9% , respectively(χ2=4.030 ,P=0.045). The acute toxicity reactions of radiotherapy and chemoradiotherapy groups were as follows. The incidences of acute grades 3-4 hematological toxicity were 9.7% and 42.4% in radiotherapy group and chemoradiotherapy groups respectively (χ2=21.362 ,P=0.000) ,and the incidences of acute grade 3 gastrointestinal toxicity were 5.9% and 9.1% (χ2=0.086 ,P=0.769)in radiotherapy group and chemoradiotherapy group ,respectively.No grade 4 gastrointestinal toxicity was found.Multivariate Cox regression analysis showed that age ,PS score , FIGO staging ,pathological type ,treatment and comorbidities were influencing factors for prognosis in elderly patients with cervical cancer (P＜0.05). Conclusions Elderly cervical cancer patients have a good tolerance to treatment. The comorbidity is one of negatively influencing factors for prognosis. The efficacy of definitive radiotherapy is inferior to surgery in elderly patients with early stage cervical cancer due to the high proportion of comorbidities.Concurrent chemoradiotherapy can improve the prognosis of middle and advanced cervical cancer in elderly patients.