Article (Scientific journals)
Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group.
Joueidi, Yolaine; Dion, Ludivine; Bendifallah, Sofiane et al.
2020In Journal of Clinical Medicine, 9 (5)
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Keywords :
chemotherapy; elderly; frailty; ovarian cancer; surgery
Abstract :
[en] Elderly women with ovarian cancer are often undertreated due to a perception of frailty. We aimed to evaluate the management of young, elderly and very elderly patients and its impact on survival in a retrospective multicenter study of women with ovarian cancer between 2007 to 2015. We included 979 women: 615 women (62.8%) <65 years, 225 (22.6%) 65-74 years, and 139 (14.2%) ≥75 years. Women in the 65-74 years age group were more likely to have serous ovarian cancer (p = 0.048). Patients >65 years had more >IIa FIGO stage: 76% for <65 years, 84% for 65-74 years and 80% for ≥75 years (p = 0.033). Women ≥75 years had less standard procedures (40% (34/84) vs. 59% (104/177) for 65-74 years and 72% (384/530) for <65 years (p < 0.001). Only 9% (13/139) of women ≥75 years had an Aletti score >8 compared with 16% and 22% for the other groups (p < 0.001). More residual disease was found in the two older groups (30%, respectively) than the younger group (20%) (p < 0.05). Women ≥75 years had fewer neoadjuvant/adjuvant cycles than the young and elderly women: 23% ≥75 years received <6 cycles vs. 10% (p = 0.003). Univariate analysis for 3-year Overall Survival showed that age >65 years, FIGO III (HR = 3.702, 95%CI: 2.30-5.95) and IV (HR = 6.318, 95%CI: 3.70-10.77) (p < 0.001), residual disease (HR = 3.226, 95%CI: 2.51-4.15; p < 0.001) and lymph node metastasis (HR = 2.81, 95%CI: 1.91-4.12; p < 0.001) were associated with lower OS. Women >65 years are more likely to have incomplete surgery and more residual disease despite more advanced ovarian cancer. These elements are prognostic factors for women's survival regardless of age. Specific trials in the elderly would produce evidence-based medicine and guidelines for ovarian cancer management in this population.
Disciplines :
Author, co-author :
Joueidi, Yolaine
Dion, Ludivine
Bendifallah, Sofiane
Mimoun, Camille
Bricou, Alexandre
Nyangoh Timoh, Krystel
Collinet, Pierre
Touboul, Cyril
Ouldamer, Lobna
Azaïs, Henri
Dabi, Yohann
Akladios, Cherif
Canlorbe, Geoffroy
Bolze, Pierre-Adrien
Costaz, Hélène
Mezzadri, Mathieu
Gauthier, Tristan
Kridelka, Frédéric ;  Université de Liège - ULiège > Département des sciences cliniques > Gynécologie-Obstétrique
Chauvet, Pauline
Bourdel, Nicolas
Koskas, Martin
Carcopino, Xavier
Raimond, Emilie
Graesslin, Olivier
Lecointre, Lise
Ballester, Marcos
Huchon, Cyrille
Levêque, Jean
Lavoué, Vincent
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Title :
Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group.
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Journal title :
Journal of Clinical Medicine
Publisher :
MDPI, Basel, Switzerland
Volume :
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