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Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group
Elderly women with ovarian cancer are often undertreated due to a perception of frailty. We aimed to evaluate the management of young, elderly and very elderly patients and its impact on survival in a retrospective multicenter study of women with ovarian cancer between 2007 to 2015. We included 979...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290352/ https://www.ncbi.nlm.nih.gov/pubmed/32414065 http://dx.doi.org/10.3390/jcm9051451 |
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author | Joueidi, Yolaine Dion, Ludivine Bendifallah, Sofiane Mimoun, Camille Bricou, Alexandre Nyangoh Timoh, Krystel Collinet, Pierre Touboul, Cyril Ouldamer, Lobna Azaïs, Henri Dabi, Yohann Akladios, Cherif Canlorbe, Geoffroy Bolze, Pierre-Adrien Costaz, Hélène Mezzadri, Mathieu Gauthier, Tristan Kridelka, Frederic Chauvet, Pauline Bourdel, Nicolas Koskas, Martin Carcopino, Xavier Raimond, Emilie Graesslin, Olivier Lecointre, Lise Ballester, Marcos Huchon, Cyrille Levêque, Jean Lavoué, Vincent |
author_facet | Joueidi, Yolaine Dion, Ludivine Bendifallah, Sofiane Mimoun, Camille Bricou, Alexandre Nyangoh Timoh, Krystel Collinet, Pierre Touboul, Cyril Ouldamer, Lobna Azaïs, Henri Dabi, Yohann Akladios, Cherif Canlorbe, Geoffroy Bolze, Pierre-Adrien Costaz, Hélène Mezzadri, Mathieu Gauthier, Tristan Kridelka, Frederic Chauvet, Pauline Bourdel, Nicolas Koskas, Martin Carcopino, Xavier Raimond, Emilie Graesslin, Olivier Lecointre, Lise Ballester, Marcos Huchon, Cyrille Levêque, Jean Lavoué, Vincent |
author_sort | Joueidi, Yolaine |
collection | PubMed |
description | Elderly women with ovarian cancer are often undertreated due to a perception of frailty. We aimed to evaluate the management of young, elderly and very elderly patients and its impact on survival in a retrospective multicenter study of women with ovarian cancer between 2007 to 2015. We included 979 women: 615 women (62.8%) <65 years, 225 (22.6%) 65–74 years, and 139 (14.2%) ≥75 years. Women in the 65–74 years age group were more likely to have serous ovarian cancer (p = 0.048). Patients >65 years had more >IIa FIGO stage: 76% for <65 years, 84% for 65–74 years and 80% for ≥75 years (p = 0.033). Women ≥75 years had less standard procedures (40% (34/84) vs. 59% (104/177) for 65–74 years and 72% (384/530) for <65 years (p < 0.001). Only 9% (13/139) of women ≥75 years had an Aletti score >8 compared with 16% and 22% for the other groups (p < 0.001). More residual disease was found in the two older groups (30%, respectively) than the younger group (20%) (p < 0.05). Women ≥75 years had fewer neoadjuvant/adjuvant cycles than the young and elderly women: 23% ≥75 years received <6 cycles vs. 10% (p = 0.003). Univariate analysis for 3-year Overall Survival showed that age >65 years, FIGO III (HR = 3.702, 95%CI: 2.30–5.95) and IV (HR = 6.318, 95%CI: 3.70–10.77) (p < 0.001), residual disease (HR = 3.226, 95%CI: 2.51–4.15; p < 0.001) and lymph node metastasis (HR = 2.81, 95%CI: 1.91–4.12; p < 0.001) were associated with lower OS. Women >65 years are more likely to have incomplete surgery and more residual disease despite more advanced ovarian cancer. These elements are prognostic factors for women’s survival regardless of age. Specific trials in the elderly would produce evidence-based medicine and guidelines for ovarian cancer management in this population. |
format | Online Article Text |
id | pubmed-7290352 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72903522020-06-15 Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group Joueidi, Yolaine Dion, Ludivine Bendifallah, Sofiane Mimoun, Camille Bricou, Alexandre Nyangoh Timoh, Krystel Collinet, Pierre Touboul, Cyril Ouldamer, Lobna Azaïs, Henri Dabi, Yohann Akladios, Cherif Canlorbe, Geoffroy Bolze, Pierre-Adrien Costaz, Hélène Mezzadri, Mathieu Gauthier, Tristan Kridelka, Frederic Chauvet, Pauline Bourdel, Nicolas Koskas, Martin Carcopino, Xavier Raimond, Emilie Graesslin, Olivier Lecointre, Lise Ballester, Marcos Huchon, Cyrille Levêque, Jean Lavoué, Vincent J Clin Med Article Elderly women with ovarian cancer are often undertreated due to a perception of frailty. We aimed to evaluate the management of young, elderly and very elderly patients and its impact on survival in a retrospective multicenter study of women with ovarian cancer between 2007 to 2015. We included 979 women: 615 women (62.8%) <65 years, 225 (22.6%) 65–74 years, and 139 (14.2%) ≥75 years. Women in the 65–74 years age group were more likely to have serous ovarian cancer (p = 0.048). Patients >65 years had more >IIa FIGO stage: 76% for <65 years, 84% for 65–74 years and 80% for ≥75 years (p = 0.033). Women ≥75 years had less standard procedures (40% (34/84) vs. 59% (104/177) for 65–74 years and 72% (384/530) for <65 years (p < 0.001). Only 9% (13/139) of women ≥75 years had an Aletti score >8 compared with 16% and 22% for the other groups (p < 0.001). More residual disease was found in the two older groups (30%, respectively) than the younger group (20%) (p < 0.05). Women ≥75 years had fewer neoadjuvant/adjuvant cycles than the young and elderly women: 23% ≥75 years received <6 cycles vs. 10% (p = 0.003). Univariate analysis for 3-year Overall Survival showed that age >65 years, FIGO III (HR = 3.702, 95%CI: 2.30–5.95) and IV (HR = 6.318, 95%CI: 3.70–10.77) (p < 0.001), residual disease (HR = 3.226, 95%CI: 2.51–4.15; p < 0.001) and lymph node metastasis (HR = 2.81, 95%CI: 1.91–4.12; p < 0.001) were associated with lower OS. Women >65 years are more likely to have incomplete surgery and more residual disease despite more advanced ovarian cancer. These elements are prognostic factors for women’s survival regardless of age. Specific trials in the elderly would produce evidence-based medicine and guidelines for ovarian cancer management in this population. MDPI 2020-05-13 /pmc/articles/PMC7290352/ /pubmed/32414065 http://dx.doi.org/10.3390/jcm9051451 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Joueidi, Yolaine Dion, Ludivine Bendifallah, Sofiane Mimoun, Camille Bricou, Alexandre Nyangoh Timoh, Krystel Collinet, Pierre Touboul, Cyril Ouldamer, Lobna Azaïs, Henri Dabi, Yohann Akladios, Cherif Canlorbe, Geoffroy Bolze, Pierre-Adrien Costaz, Hélène Mezzadri, Mathieu Gauthier, Tristan Kridelka, Frederic Chauvet, Pauline Bourdel, Nicolas Koskas, Martin Carcopino, Xavier Raimond, Emilie Graesslin, Olivier Lecointre, Lise Ballester, Marcos Huchon, Cyrille Levêque, Jean Lavoué, Vincent Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group |
title | Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group |
title_full | Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group |
title_fullStr | Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group |
title_full_unstemmed | Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group |
title_short | Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group |
title_sort | management and survival of elderly and very elderly patients with ovarian cancer: an age-stratified study of 1123 women from the francogyn group |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290352/ https://www.ncbi.nlm.nih.gov/pubmed/32414065 http://dx.doi.org/10.3390/jcm9051451 |
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