Department of Gynecology and Obstetrics, Campus Virchow Clinic, Charité University Hospital, Augustenburger Platz 1, 13353 Berlin, Germany.
Int J Gynecol Cancer. 2010 Jan;20(1):34-40. doi: 10.1111/IGC.0b013e3181c10c04.
Geriatric population life expectancy is increasing and so is the incidence of epithelial ovarian cancer (EOC) in elderly women. The aim of our study was to determine the impact of radical cytoreductive surgery, the cornerstone of clinical management in primary EOC, in this population with special regard to the associated morbidity.
Through a pooled data analysis, cancer-related patient characteristics, intraoperative tumor pattern, and surgical and clinical outcomes were evaluated according to a validated documentation data collection tool. Kaplan-Meier curves were calculated for overall survival (OS). The Cox regression analysis was performed to identify independent predictors of mortality.
One hundred one EOC patients older than 69 years (mean [SD] age, 75.54 [4.49] years) were evaluated. The mean (SD) follow-up period was 22.63 (22.92) months. Advanced International Federation of Gynecology and Obstetrics stage III (60.4%) was the most common tumor stage. A complete tumor resection was achieved in 45 patients (44.6%) with an associated complication rate of 40.6%. The postoperative mortality was 6%. The mean OS was 47.29 months (95% confidence interval, 36.24-58.34). The multivariate analysis identified age older than 75 years, incomplete tumor resection, and absence of adjuvant chemotherapy to negatively affect OS.
Radical surgery for primary EOC obtaining complete tumor resection is associated with a significantly prolonged OS in elderly patients (> or =70 years). The increased postoperative morbidity must be considered, underlining the high requirement for special interdisciplinary postoperative management in this special collective.
老年人口的预期寿命在延长，老年女性上皮性卵巢癌（EOC）的发病率也在上升。我们研究的目的是确定根治性细胞减灭术的影响，这是原发性 EOC 临床管理的基石，特别是考虑到相关发病率。
通过汇总数据分析，根据经过验证的文档数据收集工具评估癌症相关患者特征、术中肿瘤模式以及手术和临床结局。计算总生存期（OS）的 Kaplan-Meier 曲线。进行 Cox 回归分析以确定死亡率的独立预测因素。
评估了 101 例年龄大于 69 岁（平均[SD]年龄，75.54 [4.49] 岁）的 EOC 患者。平均（SD）随访时间为 22.63（22.92）个月。国际妇产科联合会（FIGO）晚期 III 期（60.4%）是最常见的肿瘤分期。45 例患者（44.6%）实现了完全肿瘤切除，相关并发症发生率为 40.6%。术后死亡率为 6%。平均 OS 为 47.29 个月（95%置信区间，36.24-58.34）。多变量分析确定年龄大于 75 岁、不完全肿瘤切除和无辅助化疗是影响 OS 的负面因素。
对原发性 EOC 进行根治性手术，获得完全肿瘤切除与老年患者（≥70 岁）显著延长的 OS 相关。必须考虑到术后发病率的增加，这突出了在这个特殊人群中对特殊的多学科术后管理的高要求。
