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Tytuł pozycji:

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

Tytuł:
Oncologic outcomes in elderly patients who underwent hysterectomy for endometrial cancer: a multi-institutional survey in Kinki District, Japan.
Autorzy:
Tanaka T; Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan. .
Yamashita S; Department of Obstetrics and Gynecology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Kuroboshi H; Department of Obstetrics and Gynecology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Kamibayashi J; Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan.
Sugiura A; Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, Japan.
Yoriki K; Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Mori T; Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Tanaka K; Department of Obstetrics and Gynecology, Izumiotsu Municipal Hospital, Izumiotsu, Japan.
Nagashima A; Department of Obstetrics and Gynecology, Izumiotsu Municipal Hospital, Izumiotsu, Japan.
Maeda M; Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan.
Kamiura S; Department of Gynecology, Osaka International Cancer Institute, Osaka, Japan.
Mizuno Y; Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Kobe, Japan.
Ohtake N; Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Kobe, Japan.
Ichimura T; Department of Obstetrics and Gynecology, Osaka City University, Osaka, Japan.
Kikuchi T; Department of Obstetrics and Gynecology, Osaka City University, Osaka, Japan.
Nobuta Y; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Ōtsu, Japan.
Amano T; Department of Obstetrics and Gynecology, Shiga University of Medical Science, Ōtsu, Japan.
Matsumura N; Department of Obstetrics and Gynecology, Kindai University, Higashiosaka, Japan.
Nakai H; Department of Obstetrics and Gynecology, Kindai University, Higashiosaka, Japan.
Kobayashi E; Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
Kamei Y; Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
Ukita M; Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Hamanishi J; Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Hirayama J; Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan.
Mabuchi Y; Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan.
Kato S; Department of Obstetrics and Gynecology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
Fujita H; Department of Obstetrics and Gynecology, Kyoto Second Red Cross Hospital, Kyoto, Japan.
Kiyota A; Department of Obstetrics and Gynecology, Osaka Police Hospital, Osaka, Japan.
Koyama S; Department of Obstetrics and Gynecology, Osaka Police Hospital, Osaka, Japan.
Fukui Y; Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Kimura M; Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Takahashi R; Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Terai Y; Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Suruga M; Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan.
Kawanishi M; Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan.
Nishioka K; Department of Obstetrics and Gynecology, Kindai University Nara Hospital, Ikoma, Japan.
Ohmichi M; Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
Źródło:
International journal of clinical oncology [Int J Clin Oncol] 2022 Jun; Vol. 27 (6), pp. 1084-1092. Date of Electronic Publication: 2022 Mar 14.
Typ publikacji:
Journal Article; Multicenter Study
Język:
English
Imprint Name(s):
Publication: 1998- : Tokyo : Springer-Verlag Tokyo
Original Publication: Tokyo : Published for the Japan Society of Clinical Oncology by Churchill Livingstone, c1996-
MeSH Terms:
Endometrial Neoplasms*/pathology
Hysterectomy*/methods
Aged ; Female ; Humans ; Japan ; Lymph Node Excision/methods ; Neoplasm Staging ; Retrospective Studies
References:
Cancer Incidence of Japan 2018 (2021) Cancer and Disease Control Division Ministry of Health, Labour and Welfare. https://www.mhlw.go.jp/content/10900000/000794199.pdf . Accessed 19 Oct 2021.
National Comprehensive Cancer Network. Uterine Neoplasm (Version 1.2021) (2021) https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf . Accessed n 19 Oct 2021.
Eggemann H, Ignatov T, Burger E et al (2017) Management of elderly women with endometrial cancer. Gynecol Oncol 146(3):519–524. https://doi.org/10.1016/j.ygyno.2017.06.029. (PMID: 10.1016/j.ygyno.2017.06.02928666541)
Benito V, Lubrano A, Andújar M et al (2019) Management of endometrial cancer in patients aged 80 years and older: identifying patients who may benefit from a curative treatment. Eur J Obstet Gynecol Reprod Biol 242:36–42. https://doi.org/10.1016/j.ejogrb.2019.09.007. (PMID: 10.1016/j.ejogrb.2019.09.00731550627)
Alemdaroglu S, Durdag GD, Baran SY et al (2021) Prognostic factors of endometrial cancer in elderly patient group and their effects on survival. North Clin Istanbul 8(4):345–353. https://doi.org/10.14744/nci.2020.47154. (PMID: 10.14744/nci.2020.47154)
Clark LH, Jackson AL, Gehrig PA et al (2016) Adjuvant treatment and clinical trials in elderly patients with endometrial cancer: a time for change? Int J Gynecol Cancer 26(2):282–289. https://doi.org/10.1097/igc.0000000000000605. (PMID: 10.1097/igc.000000000000060526745698)
Tanaka T, Ueda S, Miyamoto S et al (2020) Oncologic outcomes for patients with endometrial cancer who received minimally invasive surgery: a retrospective observational study. Int J Clin Oncol. https://doi.org/10.1007/s10147-020-01744-4. (PMID: 10.1007/s10147-020-01744-4332253967680712)
Walker JL, Piedmonte MR, Spirtos NM et al (2009) Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol 27(32):5331–5336. https://doi.org/10.1200/jco.2009.22.3248. (PMID: 10.1200/jco.2009.22.3248198056792773219)
Walker JL, Piedmonte MR, Spirtos NM et al (2012) Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group LAP2 Study. J Clin Oncol 30(7):695–700. https://doi.org/10.1200/jco.2011.38.8645. (PMID: 10.1200/jco.2011.38.8645222910743295548)
Bishop EA, Java JJ, Moore KN et al (2018) Surgical outcomes among elderly women with endometrial cancer treated by laparoscopic hysterectomy: a NRG/Gynecologic Oncology Group study. Am J Obstet Gynecol 218(1):109.e101-109.e111. https://doi.org/10.1016/j.ajog.2017.09.026. (PMID: 10.1016/j.ajog.2017.09.026)
Zhou L, Guo F, Li D et al (2020) Short- and long-term outcomes of laparoscopic surgery for elderly patients with clinical stage I endometrial cancer. J BUON 25(2):764–771. (PMID: 32521865)
Hotton J, Koual M, Gosset M et al (2020) Outcomes of robotic surgery for endometrial cancer in elderly women. Surg Oncol 33:24–29. https://doi.org/10.1016/j.suronc.2019.12.010. (PMID: 10.1016/j.suronc.2019.12.01032561088)
Rousselin A, Bendifallah S, Nyangoh Timoh K et al (2017) Patterns of care and the survival of elderly patients with high-risk endometrial cancer: A case-control study from the FRANCOGYN group. Eur J Surg Oncol 43(11):2135–2142. https://doi.org/10.1016/j.ejso.2017.07.019. (PMID: 10.1016/j.ejso.2017.07.01928888799)
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Contributed Indexing:
Keywords: Elderly cancer; Endometrial cancer; Treatment outcomes
Entry Date(s):
Date Created: 20220314 Date Completed: 20220523 Latest Revision: 20220523
Update Code:
20240105
DOI:
10.1007/s10147-022-02152-6
PMID:
35287187
Czasopismo naukowe
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.
(© 2022. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.)

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