Management and prognosis of uterine sarcoma in elderly

Background: Uterine sarcomas (US) are a rare heterogeneous group of malignancies which management remains challenging. Although elderly population is increasing, there is a lack of information about the special features of the disease in these patients. The objective of this study is to analyze the impact of age on the management and oncological outcomes of US. Methods: A retrospective multicenter study collected data from patients with US from January 2001 to December 2007. Data from patients diagnosed with adenosarcoma (AS), endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS) and undifferentiated sarcoma were included and classified depending on age (cut-off point 70 years old). Overall survival (OS) and progression-free survival (PFS), as well as cancer-specific survival (CSS) were estimated using Kaplan-Meier method for both groups. Results: In total, 688 patients were included, of whom 122 (17.73%) were elderly. Median OS and CSS were 126 and 136 months for non-elderly patients and 115 months for both OS and CSS in elderly patients, respectively. No statistical differences in either OS or CSS were found between both groups. Incomplete cytoreduction and International Federation of Gynecology and Obstetrics (FIGO) stage at diagnosis were related to OS; however, no statistical differences were found between elderly and non-elderly patients in the stratified analysis when considering minimal residual disease (P=0.85) and gross residual disease (P=0.42). Conclusions: Age alone is not a contraindication for treatment with curative intention because. In addition, these elderly patients do not have a different CSS compared to younger patients so maximal surgical effort should be carried out.