Endometrial cancer in the elderly: does patient age influence the choice of treatment interventions and do age-related treatment choices impact survival?

The increasing prevalence of cancer in the elderly: An investigation of epidemiological trends

Cancer poses a significant health threat to the elderly, accounting for a substantial proportion of cancer patients aged 65 and above. As life expectancy continues to rise and the population ages, the incidence of cancer in the elderly is expected to increase further. Age is a major risk factor for the majority of common cancers, with the incidence and prevalence rising as individuals grow older. Factors such as chemoprevention and environmental carcinogen elimination may influence the process of carcinogenesis. Studies reveal that the incidence and mortality rates of various cancers in the elderly and extremely old individuals are on the rise worldwide, with most types peaking around the age of 75 to 90, followed by a sharp decline. Birth cohort and period effects also play a complex role in the connection between aging and cancer risk. Clinical trials often exclude older individuals, limiting our understanding of cancer treatments' effects on this particular age group. More research is needed to focus on the unique requirements of older adults with cancer.

Prognostic Value of Quantitative Perfusion Parameters by Enhanced Ultrasound in Endometrial Cancer

Background

Tumor perfusion is significantly associated with the development and aggressiveness of endometrial cancer. The aim of this study was to assess the prognostic value of quantitative perfusion parameters measured by contrast-enhanced ultrasonography (CEUS) in endometrial cancer before surgery.

Material/Methods

A total of 223 patients with endometrial cancer were included between 1 May 1 2013 and 1 May 1 2017 for preoperative CEUS. The mean enhancement rate (ER) was calculated as enhancement intensity (EI)/rise time (RT) results from time-intensity curve (TIC) during CEUS. After a mean follow-up of 33.5±9.9 months, the correlation of ER and postoperative overall survival (OS) and disease-free survival (DFS) was analyzed using univariate and multivariate analysis.

Results

The optimal cutoff ER value predicting survival based on the ROC curve was 1.8 dB/s. Kaplan-Meier univariate analysis demonstrated that a patient with a high ER level had worse DFS and OS than those with a low ER (DFS, P<0.01; OS, P<0.05). In multivariate analysis, ER was confirmed as an independent predictor for both recurrence (HR, 1.68; 95% CI: 1.01–7.73) and OS (HR, 1.98; 95%CI: 1.01–7.83) for patients with endometrial cancer (both P<0.05).

Conclusions

Perfusion variables measured by CEUS are significantly useful predictive factor for postoperative survival in endometrial cancer.