Clinical Interventions in Aging (Jun 2020)
Characteristics and Treatments of Patients Aged 65 Years or Over with Cervical Cancer
Abstract
Shangdan Xie,1 Shuya Pan,1 Shuangwei Zou,1 Haiyan Zhu,2 Xueqiong Zhu1 1Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 2Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Haiyan ZhuDepartment of Gynecology, Shanghai First Maternity and Infant Hospital, No. 2699 Gaoke West Road, Shanghai, Pudong 200126 People’s Republic of ChinaTel/ Fax +86 13758465255Email [email protected] ZhuDepartment of Obstetrics and Gynecology, The Second Affiliated Hospital of Wenzhou Medical University, No. 109 Xueyuan Xi Road, Zhejiang, Wenzhou 325027, People’s Republic of ChinaTel/ Fax +86 577 88002796Email [email protected]: Although the mortality of elderly women with cervical cancer is high, their characteristics and prognosis have not attracted sufficient attention. This study aims to clarify the prognostic factors of cervical cancer patients aged ≥ 65.Patient and Methods: The incidences and characteristics of patients diagnosed with cervical cancer (aged ≥ 65 and < 65) during 2004– 2015 were obtained through the Surveillance, Epidemiology, and End Results Program (SEER) database. The differences of distributions of characteristics between two age groups were compared by chi-squared (χ2) test. Kaplan–Meier survival method, Log-rank test, Cox-regression and visual nomogram were utilized for survival analysis.Results: The annual incidences of two age groups with cervical cancer were (5.5– 7.5)/100,000 and (3.4– 3.9)/100,000, respectively, during 2004– 2015. The 1-year and 5-year cancer-specific survival rates of old patients were both lower than those of young patients (P < 0.001). The proportions of unmarried state and advanced International Federation of Gynecology and Obstetrics (FIGO) stage in old patients were higher than those in relatively young patients, and fewer elderly patients received surgery. Univariate and multivariate survival analysis showed non-squamous cell carcinoma, poor differentiation and late FIGO stage were independent poor prognostic factors for patients aged ≥ 65. Treatments improved the outcomes of elderly patients, and the effect of surgery was better than non-surgical treatment on elderly patients with FIGO I. Besides, geriatric score and survival probability could be accomplished by our nomogram with a c-index of 0.7945.Conclusion: Delayed diagnosis and insufficient treatment were two distinct features of elderly patients and correlated with their poor clinical outcomes. More attention and active treatments should be adopted in elderly women based on their general condition.Keywords: cervical cancer, elderly, database analysis, prognosis
