Ovarian cancer in elderly patients: a difference in treatment based on age?

PURPOSE

The aim of this study was to examine if treatment strategies differ by age in the elderly population with ovarian cancer in daily clinical practice.

METHODS

A retrospective analysis of elderly patients with ovarian cancer who were referred to our institution between January 2007 and August 2010 was done. A univariate analysis for overall survival was estimated according to the Kaplan-Meier method, censoring surviving patients at the time of last follow-up.

RESULTS

We evaluated 32 elderly patients: 17 "young-old" patients (65-74 years old), 14 "old-old" patients (75-84 years old) and 1 "oldest-old" patient (≥85 years old). At last follow-up, 20 patients (62.5%) were alive and 12 patients (37.5%) were deceased. Median time follow-up was 18.52 months. Median overall survival was 19.05 months. Median age was 73.50 years. In the subgroup of "young-old" patients, there were less "high malignant potential" (64.3 vs. 70.0%) and grade 3 ovarian cancers (84.6 vs. 90.0%), less advanced stages (III-IV: 64.7 vs. 86.7%), higher number of optimal surgical procedures (50.0 vs. 30.0%) and more frequent use of chemotherapy (82.4 vs. 66.7%). Single agent carboplatin was administered in 81.8 vs. 77.8% of "young-old" and "old-oldest old" patients, and average number of lines was 2 vs. 1. Other characteristics were similar in the two subgroups ("young-old" vs. "old-oldest old" patients). By the univariate analysis, there was no statistical significance difference in overall survival (p=0.393) between the two subgroups, with only a positive trend for young-old patients.

CONCLUSIONS

In old- and oldest-old patients, the characteristics of disease are worse and optimal treatment strategy is less frequently applied. The management of patients by multidisciplinary team is needed and it could better individualize and apply the optimal treatment approach.