Long-term treatment outcomes in cervical cancer patients aged 60 years and above: A comprehensive 12-year study in the Indian context

Abstract

Background: Cervical cancer remains a significant global health concern, with around 570,000 new cases and 310,000 deaths annually. Despite a decrease in incidence due to screening programs, rates among elderly women, typically aged 50 and above have remained steady. These demographic faces unique physiological and pathological factors, impacting treatment decisions and outcomes. Treatment of Cervical cancer is a multimodality approach which includes Surgery, concurrent chemo radiation, brachytherapy and in some cases Neoadjuvant chemotherapy determined by staging. However, the suitability of these treatments for elderly patients, considering their frailty, co morbidities, and age-related issues like malnutrition and cognitive decline, remains underexplored. There's a critical need to balance treatment benefits with risks, aiming to reduce mortality by individualizing care. Materials and Methods: A retrospective study in India analyzed outcomes for elderly cervical cancer patients over 12 years. Out of 876 patients reviewed, 186 met inclusion criteria: aged 60 or older, with FIGO Stage IB to IVA and ECOG performance status I to III. Results: The majority (61%) of patients were aged 60-65. Most had ECOG PS II status, and 96% had squamous cell carcinoma. Around 62.3% had locally advanced disease. Survival rates were highest in FIGO Stage IB, with overall survival statistically significant at 92.09 months, and disease-free interval at 103.24 months. Conclusion: The study suggests age may not independently predict outcomes for elderly cervical cancer patients in India. Despite co morbidities necessitating treatment adjustments, radical management remains crucial, irrespective of age. Tailoring treatments to individual needs and improving survival prediction are essential for better outcomes in this population.