老年卵巢上皮性癌的预后因素：一项病例对照研究。

Prognostic factors for ovarian epithelial cancer in the elderly: a case-control study.

作者信息

Sabatier Renaud, Calderon Benoît, Lambaudie Eric, Chereau Elisabeth, Provansal Magali, Cappiello Maria-Antonietta, Viens Patrice, Rousseau Frederique

机构信息

*Department of Medical Oncology, Institut Paoli-Calmettes; †Department of Molecular Oncology, INSERM U1068, CNRS U7258, Centre de Recherche en Cancérologie de Marseille; ‡Aix-Marseille University; and §Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France.

出版信息

Int J Gynecol Cancer. 2015 Jun;25(5):815-22. doi: 10.1097/IGC.0000000000000418.

DOI:10.1097/IGC.0000000000000418

PMID:25768081

Abstract

OBJECTIVES

Ovarian cancer is the leading cause of mortality by gynecologic cancers in Western countries. Many publications have suggested that age may be an independent prognostic factor in ovarian carcinoma. There are only few data concerning the impact of treatments and geriatric features within the elderly population.

METHODS/MATERIALS: We collected data of older (≥ 70 years old) patients treated in our institution for an invasive ovarian carcinoma between 1995 and 2011. First we described usual clinical and pathological features for these patients, as well as their outcome. We compared these parameters with that of young (<70 years old) patients treated during the same period. We then observed geriatric features in our set: Eastern Cooperative Oncology Group performance status, number of medications, Charlson index, body mass index, hemoglobin, and glomerular filtration rate. We finally looked for prognostic factors specific of the elderly population.

RESULTS

One hundred nine elderly patients were identified and compared with 488 younger cases. There was no difference concerning clinicopathologic data. Surgery was more frequently complete in young women (58% vs 41.7%), and older patients received less chemotherapy courses and less taxanes (38.4% vs 67.1%). Young patients had a longer overall survival (median, 65.2 vs 26.2 months, P = 8.5E-10, log-rank test). Multivariate analyses confirmed that age was an independent prognostic factor and that within the elderly set the International Federation of Gynecology and Obstetrics stage, surgery results, number of chemotherapy cycles administered and performance status had a significant prognostic value. No clear correlation could be observed between geriatric characteristics and treatments administration.

CONCLUSIONS

Ovarian cancer prognosis is poorer for older women, but they are more frequently suboptimally treated. No correlation could be observed between geriatric factors and surgery or chemotherapy achievement. Treatment decision should be based on objective geriatric assessment in order to improve outcome in this population.

摘要

目的

在西方国家，卵巢癌是妇科癌症致死的主要原因。许多出版物表明年龄可能是卵巢癌的一个独立预后因素。关于老年人群中治疗和老年特征的影响，仅有少量数据。

方法/材料：我们收集了1995年至2011年间在我们机构接受侵袭性卵巢癌治疗的老年（≥70岁）患者的数据。首先，我们描述了这些患者的常见临床和病理特征以及他们的预后情况。我们将这些参数与同期治疗的年轻（<70岁）患者的参数进行了比较。然后，我们观察了我们研究组中的老年特征：东部肿瘤协作组体能状态、用药数量、查尔森指数、体重指数、血红蛋白和肾小球滤过率。我们最终寻找老年人群特有的预后因素。

结果

确定了109例老年患者，并与488例年轻病例进行了比较。临床病理数据方面没有差异。年轻女性手术更常为根治性手术（58%对41.7%），老年患者接受的化疗疗程和紫杉烷类药物较少（38.4%对67.1%）。年轻患者的总生存期更长（中位数，65.2个月对26.2个月，P = 8.5E - 10，对数秩检验）。多因素分析证实年龄是一个独立的预后因素，并且在老年组中，国际妇产科联盟分期、手术结果、化疗周期数和体能状态具有显著的预后价值。未观察到老年特征与治疗实施之间有明显相关性。