Susini T, Amunni G, Busi E, Villanucci A, Carriero C, Taddei G, Marchionni M, Scarselli G
Department of Gynecology, Perinatology and Reproductive Medicine, University of Florence, Florence, Italy.
Int J Gynecol Cancer. 2007 May-Jun;17(3):581-8. doi: 10.1111/j.1525-1438.2007.00836.x. Epub 2007 Feb 9.
Gynecological oncologists are faced with an increasing proportion of geriatric ovarian cancer patients. Comorbidities are frequently a matter of concern in this age group, and what is adequate treatment for such patients is still debated. The aims of this study were to analyze the feasibility of standard surgery and chemotherapy in a series of elderly ovarian cancer patients (>/=70 years) and to investigate the influence of age (70-75 vs >75 years) on survival. We retrospectively evaluated 89 elderly patients treated at our department between 1985 and 2005. Comorbidities, type of surgical procedure, complications, drugs and schedules of chemotherapy, number of cycles, toxicity, and clinical outcome were registered. Comorbidities were present in 71.9%. Only six patients were inoperable. Among the 83 patients who underwent surgery, 76.4% received adequate surgical treatment. Severe postoperative complications occurred in 16.8%, operative mortality was zero. A total of 801 cycles of chemotherapy were administered to 77 patients (median 10; range 1-38). Overall, G3-G4 toxicity was documented in 61.0%. The rates of dose reduction, treatment delay, and discontinuation were 13.0%, 20.7%, and 3.9%, respectively. Patients who received adequate surgery and those with residual disease <1 cm did significantly better than their counterparts (P= 0.04 and P < 0.001, respectively). No difference in survival according to age (70-75 vs >75 years) was found. Standard surgery and chemotherapy were feasible in elderly ovarian cancer patients. The type of surgery and the amount of residual disease, but not the age of the patients, significantly influenced the clinical outcome.
妇科肿瘤学家面对的老年卵巢癌患者比例日益增加。合并症在这个年龄组中常常是一个令人担忧的问题，而对此类患者何种治疗才恰当仍存在争议。本研究的目的是分析一系列老年卵巢癌患者（≥70岁）进行标准手术和化疗的可行性，并调查年龄（70 - 75岁与>75岁）对生存的影响。我们回顾性评估了1985年至2005年间在我科接受治疗的89例老年患者。记录了合并症、手术方式、并发症、化疗药物及方案、周期数、毒性和临床结局。71.9%的患者存在合并症。只有6例患者无法手术。在83例接受手术的患者中，76.4%接受了充分的手术治疗。术后严重并发症发生率为16.8%，手术死亡率为零。共对77例患者进行了801个周期的化疗（中位数10；范围1 - 38）。总体而言，61.0%记录到3 - 4级毒性。剂量减少、治疗延迟和停药率分别为13.0%、20.7%和3.9%。接受充分手术的患者以及残留病灶<1 cm的患者的情况明显优于相应的对照组（分别为P = 0.04和P < 0.001）。未发现年龄（70 - 75岁与>75岁）对生存有差异。标准手术和化疗在老年卵巢癌患者中是可行的。手术方式和残留病灶量而非患者年龄对临床结局有显著影响。
