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Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan

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Abstract

Background

The goal of this study is to assess the oncologic outcomes of elderly patients who underwent hysterectomy for endometrial cancer across three variables: hysterectomy approach, lymph node resection, and adjuvant therapy.

Methods

Hospital records of patients aged ≥ 70 years who underwent hysterectomy for endometrial cancer were obtained from 19 institutions. Patients were categorized into three risk groups: low, intermediate, and high. In each group, disease-free survival and overall survival were compared according to hysterectomy approach, lymph node resection, and adjuvant therapy using Kaplan–Meier method. Cox regression analysis with a 95% confidence interval was performed to estimate relative risk (RR) of death.

Results

A total of 1246 patients were included. In the low-risk group, the adjusted RR for death for minimally invasive surgery (MIS) versus laparotomy and lymph node resection versus no lymph node resection were 0.64 (0.24–1.72) and 0.52 (0.24–1.12), respectively. In the intermediate-risk group, the adjusted RR for death for MIS versus laparotomy, lymph node resection versus no lymph node resection, and adjuvant therapy versus no adjuvant therapy were 0.80 (0.36–1.77), 0.60 (0.37–0.98), and 0.89 (0.55–1.46), respectively. In the high-risk group, the adjusted RRs for death for lymph node resection versus no lymph node resection and adjuvant therapy versus no adjuvant therapy were 0.56 (0.37–0.86) and 0.60 (0.38–0.96), respectively.

Conclusions

MIS is not inferior to laparotomy in uterine-confined diseases. Lymph node resection improved the outcome for all disease stages and histological types. In contrast, adjuvant therapy improved the outcomes only in high-risk patients.

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Funding

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan

    Tomohito Tanaka & Masahide Ohmichi

  2. Department of Obstetrics and Gynecology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Suguru Yamashita & Haruo Kuroboshi

  3. Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan

    Junya Kamibayashi & Atsushi Sugiura

  4. Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan

    Kaori Yoriki & Taisuke Mori

  5. Department of Obstetrics and Gynecology, Izumiotsu Municipal Hospital, Izumiotsu, Japan

    Kazuharu Tanaka & Aiko Nagashima

  6. Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan

    Michihide Maeda & Shoji Kamiura

  7. Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Kobe, Japan

    Yukako Mizuno & Noriko Ohtake

  8. Department of Obstetrics and Gynecology, Osaka City University, Osaka, Japan

    Tomoyuki Ichimura & Taiki Kikuchi

  9. Department of Obstetrics and Gynecology, Shiga University of Medical Science, Ōtsu, Japan

    Yuri Nobuta & Tsukuru Amano

  10. Department of Obstetrics and Gynecology, Kindai University, Higashiosaka, Japan

    Noriomi Matsumura & Hidekatsu Nakai

  11. Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan

    Eiji Kobayashi & Yuji Kamei

  12. Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Masayo Ukita & Junzo Hamanishi

  13. Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan

    Junya Hirayama & Yasushi Mabuchi

  14. Department of Obstetrics and Gynecology, Kyoto Second Red Cross Hospital, Kyoto, Japan

    Seiko Kato & Hiroyuki Fujita

  15. Department of Obstetrics and Gynecology, Osaka Police Hospital, Osaka, Japan

    Atsuko Kiyota & Shinsuke Koyama

  16. Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan

    Yosuke Fukui & Mai Kimura

  17. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan

    Ryosuke Takahashi & Yoshito Terai

  18. Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan

    Madoka Suruga & Masaru Kawanishi

  19. Department of Obstetrics and Gynecology, Kindai University Nara Hospital, Ikoma, Japan

    Kazuhiro Nishioka

Authors
  1. Tomohito Tanaka
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  2. Suguru Yamashita
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  3. Haruo Kuroboshi
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Correspondence to Tomohito Tanaka.

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Tanaka, T., Yamashita, S., Kuroboshi, H. et al. Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan. Int J Clin Oncol 27, 1084–1092 (2022). https://doi.org/10.1007/s10147-022-02152-6

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  • DOI: https://doi.org/10.1007/s10147-022-02152-6

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