Age as a prognostic factor for recurrence in patients with endometrial carcinoma

Purpose. The aim of this study was to evaluate age as a prognostic factor f or recurrence in endometrial cancer patients treated with primary surgery. Methods. Between 1983 and 1998, 455 endometrial cancer patients underwent p rimary surgery at our institution. Patients were divided into three age gro ups based on age at diagnosis: Group A (age <60, n = 156), B (age 60-69, n = 147), and C (age greater than or equal to 70, n = 152). Clinicopathologic , treatment factors, and outcome were compared among the three groups. Prog nostic factors were evaluated by univariate and multivariate analysis. Results. The three age groups had a similar distribution of most pathologic features including stage, histology, cervical involvement, positive cytolo gy, adnexal involvement, nodal metastases, serosal involvement, and lymphov ascular invasion (LVI). Older women had a higher rate, however, of deep (>1 /2) myometrial invasion (P < 0.0001) and grade 3 tumors (P < 0.0001). The e xtent of surgical staging and use of adjuvant radiation therapy were simila r. Five-year disease-free survivals (DFS) of Groups A, B, and C were 74.3, 70.2, and 60.3%, respectively (P = 0.08). A significant difference in DFS w as seen when Groups A and B were combined and compared with Group C (72.0 v s 60.3%, P = 0.03). Multivariate analysis confirmed the significance of rac e, stage, grade, and LVI. Age was not found to be associated with recurrenc e (HR 1.1, 95% C.I. 0.91-1.5, P = 0.21). Conclusion. Our results reveal that, in a large cohort of comparably staged and treated endometrial carcinoma patients, age is not a prognostic factor for recurrence, (C) 2000 Academic Press.