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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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.
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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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