Advanced age is a significant determinant of poor prognosis in patients treated with surgery plus postoperative radiotherapy for endometrial cancer
Advanced age is a significant determinant of poor prognosis in patients treated with surgery plus postoperative radiotherapy for endometrial cancer
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DOI：
10.1111/j.1447-0756.2010.01202.x
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发表时间：
2010-08-01
影响因子：
1.6
通讯作者：
Nakagawa, Keiichi
中科院分区：
文献类型：
--
作者：
Okuma, Kae;Yamashita, Hideomi;Nakagawa, Keiichi
目的：对我院接受手术和辅助放射治疗的子宫内膜癌患者进行年龄对生存率的影响进行综述。方法：1988 ~ 2008年111例子宫内膜癌患者行腹式全子宫切除术及辅助全盆腔放射治疗。术后无淋巴结转移的低、中危患者，不进行术后辅助治疗。对于高危或腹腔细胞学阳性的患者，术后进行放射治疗。放疗总剂量为50 ~ 50.4 Gy。44例（44%）患者接受表柔比星/顺铂/卡铂或紫杉醇/卡铂的化疗。进行单因素和多因素分析以确定重要的预后临床病理因素。结果：中位随访时间为59.2个月，60岁及以上患者的5年总生存率为74%，60岁以下患者为90% （P = 0.044）。对于无病生存率，60岁及以上的患者为65%，而60岁以下的患者为85% （P = 0.013）。在多变量分析中，无病生存率差与年龄bb0 = 60岁相关（P = 0.035）。结论：与其他预后因素和/或治疗技术无关，老年子宫内膜癌患者（年龄>= 60岁）术后接受RT治疗后的总生存率和无病生存率显著降低。
Aim:A review was conducted in which the effect of age on survival was assessed in a population of endometrial cancer patients treated with surgery and adjuvant radiation therapy in our institution.Methods:From 1988 to 2008, 111 endometrial cancer patients underwent total abdominal hysterectomy and adjuvant whole pelvic radiation therapy (RT). After surgery, for patients with low or intermediate risk without lymph node metastasis, no postoperative adjuvant therapy was performed. For patients with high risk or positive cytology from the abdominal cavity, postoperative radiation therapy was performed. A total dose of 50-50.4 Gy of RT was delivered sequentially. Forty-four patients (44%) were given chemotherapy consisting of epirubicin/cisplatin/carboplatin or paclitaxel/carboplatin. Univariate and multivariate analyses were performed to identify significant prognostic clinicopathological factors.Results:With a median follow-up time of 59.2 months, the 5-year overall survival was 74% for those 60 years or older versus 90% for those younger than 60 years (P = 0.044). For disease-free survival, it was 65% for those 60 years or older, versus 85% for those younger than 60 years (P = 0.013). On multivariate analysis, poor disease-free survival was associated with age >= 60 years (P = 0.035).Conclusions:Older patients (age >= 60 years) with endometrial cancer had significantly lower overall survival and disease-free survival following postoperative RT independent of other prognostic factors and/or treatment technique.