Management of elderly women with cervical cancer
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Elderly women with cervical cancer receive less therapy in comparison with their younger counterparts. The exact reason(s) for this treatment strategy remains unclear.
Patients and methods
We performed a multicenter, retrospective registry-based study of 1559 patients with cervical cancer. The primary outcome was the reason for not performing the indicated treatment.
Median follow-up was 67.8 months. A total of 956 women were eligible for analysis: 693 (64.2%) were younger than 60 years and 387 (35.8%) were aged 61 years old and older. Elderly women were more likely to have undifferentiated cervical cancer at an advanced stage. For early stage (stage IA1–IIA), tumors patients 61 years old and older were less likely to receive surgery [odds ratio (OR) 0.39; 95% CI 0.20–0.77] and radiochemotherapy (OR 0.37; 95% CI 0.21–0.66) compared with the group of patients aged < 60 years. The rate of lymphadenectomy was similar in both age groups. Patients 61 years old and older with advanced stage (IIB–IV) cervical cancer were also less likely to receive surgery [odds ratio (OR) 0.42; 95% CI 0.27–0.66], lymphadenectomy (OR 0.30; 95% CI 0.12–0.51) and radiochemotherapy (OR 0.31; 95% CI 0.20–0.48) compared with patients aged < 60 years. Notably, the rate of indicated but not performed therapies proportionally increased with an increase in patient age and the most important reason for this phenomenon was the failing of recommendation.
Elderly women with cervical cancer are undertreated and this is more likely because the therapy was not recommended.
KeywordsCervical cancer Elderly Radiation Lymphadenectomy Radical surgery
This study was not funded.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
This article does not contain any studies with animals performed by any of the authors. In accordance with the statement of the Research and Ethical Committee of the Otto-von-Guericke University, Magdeburg, Germany, additional individual consent for this analysis was not needed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Written informed consent was obtained from all patients before treatment. An additional individual consent for this analysis was not needed.
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