Giri Sushil K, Nayak Bhagyalaxmi
Department of Gynaecologic Oncology, A.H Regional Cancer Center, Cuttack, Odisha, India- 753007.
Rev Recent Clin Trials. 2015;10(4):270-5. doi: 10.2174/1574887110666150923112303.
As a result of increasing life expectancy, the cancer incidence in older population is on the rise. Ovarian cancer (OC) is predominantly the disease of elderly women. More than half of all OC occur in women older than 65 years. The incidence of the disease increases with the advancing age, peaking during 7(th) decade of life and remains elevated until the age of 80 years. With the changing demographic scenario the percentage of elderly patients is increasing and gynaecologic oncologists need to focus more on these patients and their specific needs. Due to their higher risk of morbidity and mortality compared to younger patients, elderly patients with advanced ovarian cancer are challenging to treat and are often treated less radically. Their outcome is impaired despite no consistent prognostic effect of age itself. To offer optimal radical management of the elderly women with ovarian cancer and to avoid suboptimal treatment, biological age and functional status need to be considered before individualized treatment plans are defined. Pretreatment assessment can be achieved by using different assessment tools. Patients can tolerate surgery and chemotherapy, as long as they are individually assessed for their medical, psychological, and functional capabilities before therapeutic intervention is initiated. Prospective trials involving elderly women with ovarian cancer are the need of the day to offer justified evidenced based optimal treatment for those who will be benefited from the treatment.
由于预期寿命的增加,老年人群中的癌症发病率正在上升。卵巢癌(OC)主要是老年女性的疾病。所有卵巢癌病例中超过一半发生在65岁以上的女性身上。该疾病的发病率随着年龄的增长而增加,在70岁左右达到峰值,并一直保持在高位直至80岁。随着人口结构的变化,老年患者的比例在增加,妇科肿瘤学家需要更多地关注这些患者及其特殊需求。与年轻患者相比,老年晚期卵巢癌患者的发病和死亡风险更高,治疗具有挑战性,且往往治疗不够彻底。尽管年龄本身并无一致的预后影响,但他们的治疗结果仍受到损害。为了为老年卵巢癌女性提供最佳的根治性治疗并避免治疗不足,在制定个体化治疗方案之前,需要考虑生物学年龄和功能状态。可以通过使用不同的评估工具来进行预处理评估。只要在开始治疗干预之前对患者的医疗、心理和功能能力进行个体评估,患者就能耐受手术和化疗。目前需要开展涉及老年卵巢癌女性的前瞻性试验,以便为那些将从治疗中受益的患者提供合理的、有循证依据的最佳治疗。