Endometrial Carcinoma in Elderly Women

Endometrial carcinoma remains the most common invasive gynecologic malignancy. Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have fo...

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Veröffentlicht in:Gynecologic oncology 1995-08, Vol.58 (2), p.198-201
Hauptverfasser: Hoffman, Karen, Nekhlyudov, Larissa, Deligdisch, Liane
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creator Hoffman, Karen
Nekhlyudov, Larissa
Deligdisch, Liane
description Endometrial carcinoma remains the most common invasive gynecologic malignancy. Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have focused on EC in the growing elderly population. This study analyzed 35 histologic specimens of EC in women 75-92 years of age. Findings revealed that only 23% of the tumors were Stage I, G1. The majority (77%) were deeply invasive or of advanced stage (IC-IV). These were G2, G3, or "virulent" types of nonendometrioid EC (undifferentiated, clear cell, uterine serious papillary, and squamous cell carcinoma). Fifty-seven percent of tumors were endometrioid, of which 9% were mixed, including a rare case of nongestational choriocarcinoma. The nonendometrioid tumors, compared to the endometrioid types, were more often high-stage tumors with vascular invasion. They were also more often associated with atrophic (vs hyperplastic) uninvolved endometrium. Clinical risk factors (nulliparity, obesity, estrogen replacement therapy) were assessed and correlated with the histologic findings. It was shown that tumors in the elderly were less likely to be estrogen-related. It was concluded that EC in this age group is more aggressive, histologically less differentiated, and often nonendometrioid compared with EC in the general population. The increased virulence of EC in the elderly may be related to the tumor's independence from hormonal factors, to the poorly understood but well-known diminished immunologic defense against cancer in general in elderly patients, and/or to the belated diagnosis of the disease in this population.
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Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have focused on EC in the growing elderly population. This study analyzed 35 histologic specimens of EC in women 75-92 years of age. Findings revealed that only 23% of the tumors were Stage I, G1. The majority (77%) were deeply invasive or of advanced stage (IC-IV). These were G2, G3, or "virulent" types of nonendometrioid EC (undifferentiated, clear cell, uterine serious papillary, and squamous cell carcinoma). Fifty-seven percent of tumors were endometrioid, of which 9% were mixed, including a rare case of nongestational choriocarcinoma. The nonendometrioid tumors, compared to the endometrioid types, were more often high-stage tumors with vascular invasion. They were also more often associated with atrophic (vs hyperplastic) uninvolved endometrium. Clinical risk factors (nulliparity, obesity, estrogen replacement therapy) were assessed and correlated with the histologic findings. It was shown that tumors in the elderly were less likely to be estrogen-related. It was concluded that EC in this age group is more aggressive, histologically less differentiated, and often nonendometrioid compared with EC in the general population. 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Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have focused on EC in the growing elderly population. This study analyzed 35 histologic specimens of EC in women 75-92 years of age. Findings revealed that only 23% of the tumors were Stage I, G1. The majority (77%) were deeply invasive or of advanced stage (IC-IV). These were G2, G3, or "virulent" types of nonendometrioid EC (undifferentiated, clear cell, uterine serious papillary, and squamous cell carcinoma). Fifty-seven percent of tumors were endometrioid, of which 9% were mixed, including a rare case of nongestational choriocarcinoma. The nonendometrioid tumors, compared to the endometrioid types, were more often high-stage tumors with vascular invasion. They were also more often associated with atrophic (vs hyperplastic) uninvolved endometrium. Clinical risk factors (nulliparity, obesity, estrogen replacement therapy) were assessed and correlated with the histologic findings. It was shown that tumors in the elderly were less likely to be estrogen-related. It was concluded that EC in this age group is more aggressive, histologically less differentiated, and often nonendometrioid compared with EC in the general population. The increased virulence of EC in the elderly may be related to the tumor's independence from hormonal factors, to the poorly understood but well-known diminished immunologic defense against cancer in general in elderly patients, and/or to the belated diagnosis of the disease in this population.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - physiology</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Endometrioid - epidemiology</subject><subject>Carcinoma, Endometrioid - pathology</subject><subject>Endometrial Neoplasms - epidemiology</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Neoplasm Staging</subject><subject>Neoplasms, Hormone-Dependent - epidemiology</subject><subject>Neoplasms, Hormone-Dependent - pathology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Tumors</subject><issn>0090-8258</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1LwzAYxoMoc06v3oQeZLfWN02TJkcZ8wMGXhSPIc2HRNp0Jp2w_96Old08vYfn9zy8_BC6xVBgAPbwtQ99gYWgBS4xnKE5BkFzxqk4R3MAATkvKb9EVyl9AwABXM7QrGblSNM5Wq6D6Ts7RK_abKWi9qHvVOZDtm6Nje0--xzjcI0unGqTvZnuAn08rd9XL_nm7fl19bjJNWF8yJkwlFesrsAI4bhwTGhVU4GNLYXmFISqATsgujRlyQhtKtE0ghNHnKackgVaHne3sf_Z2TTIzidt21YF2--SrOsK44qyESyOoI59StE6uY2-U3EvMciDGHkQIw9i5EHMWLiblndNZ80Jn0yM-f2Uq6RV66IK2qcTRhimuK5GjB8xO1r49TbKpL0N2hofrR6k6f1_H_wBvz98Og</recordid><startdate>19950801</startdate><enddate>19950801</enddate><creator>Hoffman, Karen</creator><creator>Nekhlyudov, Larissa</creator><creator>Deligdisch, Liane</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950801</creationdate><title>Endometrial Carcinoma in Elderly Women</title><author>Hoffman, Karen ; Nekhlyudov, Larissa ; Deligdisch, Liane</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-69d5846740d99f89f69ca7591de29c8509a701f03c2d22635b49bb983f3fc5853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - physiology</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Endometrioid - epidemiology</topic><topic>Carcinoma, Endometrioid - pathology</topic><topic>Endometrial Neoplasms - epidemiology</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Neoplasm Staging</topic><topic>Neoplasms, Hormone-Dependent - epidemiology</topic><topic>Neoplasms, Hormone-Dependent - pathology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoffman, Karen</creatorcontrib><creatorcontrib>Nekhlyudov, Larissa</creatorcontrib><creatorcontrib>Deligdisch, Liane</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoffman, Karen</au><au>Nekhlyudov, Larissa</au><au>Deligdisch, Liane</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endometrial Carcinoma in Elderly Women</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>1995-08-01</date><risdate>1995</risdate><volume>58</volume><issue>2</issue><spage>198</spage><epage>201</epage><pages>198-201</pages><issn>0090-8258</issn><eissn>1095-6859</eissn><coden>GYNOA3</coden><abstract>Endometrial carcinoma remains the most common invasive gynecologic malignancy. Increased longevity is associated with an increased incidence of endometrial carcinoma (EC) in elderly women. While recent studies have looked at aging and its relation to ovarian, breast, and cervical cancer, few have focused on EC in the growing elderly population. This study analyzed 35 histologic specimens of EC in women 75-92 years of age. Findings revealed that only 23% of the tumors were Stage I, G1. The majority (77%) were deeply invasive or of advanced stage (IC-IV). These were G2, G3, or "virulent" types of nonendometrioid EC (undifferentiated, clear cell, uterine serious papillary, and squamous cell carcinoma). Fifty-seven percent of tumors were endometrioid, of which 9% were mixed, including a rare case of nongestational choriocarcinoma. The nonendometrioid tumors, compared to the endometrioid types, were more often high-stage tumors with vascular invasion. They were also more often associated with atrophic (vs hyperplastic) uninvolved endometrium. Clinical risk factors (nulliparity, obesity, estrogen replacement therapy) were assessed and correlated with the histologic findings. It was shown that tumors in the elderly were less likely to be estrogen-related. It was concluded that EC in this age group is more aggressive, histologically less differentiated, and often nonendometrioid compared with EC in the general population. The increased virulence of EC in the elderly may be related to the tumor's independence from hormonal factors, to the poorly understood but well-known diminished immunologic defense against cancer in general in elderly patients, and/or to the belated diagnosis of the disease in this population.</abstract><cop>San Diego, CA</cop><pub>Elsevier Inc</pub><pmid>7622105</pmid><doi>10.1006/gyno.1995.1210</doi><tpages>4</tpages></addata></record>
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subjects Aged
Aged, 80 and over
Aging - physiology
Biological and medical sciences
Carcinoma, Endometrioid - epidemiology
Carcinoma, Endometrioid - pathology
Endometrial Neoplasms - epidemiology
Endometrial Neoplasms - pathology
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Medical sciences
Neoplasm Staging
Neoplasms, Hormone-Dependent - epidemiology
Neoplasms, Hormone-Dependent - pathology
Retrospective Studies
Risk Factors
Tumors
title Endometrial Carcinoma in Elderly Women
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