Introduction/Background*Incidence of ovarian cancer increases with age and reaches a peak at 70 years. The aim of the present study is the analysis of therapeutic differences, both surgical and pharmacological, in patients affected by ovarian cancer and stratified by age.
Methodology A multicentre retrospective study has been conducted. Patients with ovarian cancer were included and ranked at diagnosis in group A (≥70 years) and group B (<70 years). Co-morbidities, performance status, FIGO stage, grading, histotype and treatment were considered. Surgical treatment was considered as primary debulking surgery or interval debulking surgery (IDS) reporting extension, residual tumour, complications and days of hospitalization. Chemotherapy was administered for 3 or more cycles and the clinical response was evaluated.
Result(s)*459 patients were included in the study, 132 (28.8%) in group A and 327 (71.2%) in group B. Considering advanced stages optimal cytoreduction was achieved in 76.7% of younger patients and in 66.7% of older (p=0.05). IDS was especially necessary in in the elderly compared to the young ones (37.9% vs 49%; p=0.05). There was good correlation between overall survival and the performance status (p=0.0001), the age at diagnosis (p=0.001), tumour stage (p=0.0001) and residual tumour (p=0.00001).
Stratifying by stage the residual tumour (OR=2.4; p=0.0001) , age (OR=1.9 P=0.0001), and the performance status (OR=1.2; p=0.03) resulted as independent survival prognostic factors according to Cox multivariate analysis.
Conclusion*Our data suggest that patients aged ≥70 can tolerate radical surgical treatments in the same way as younger patients without a significant increase in morbidity and, obviously, without ignoring the appropriate geriatric precautions. Furthermore, maximal surgical effort with optimal cytoreduction should be considered the gold standard regardless of age.
Therefore, our data underlines the importance of managing these patients within Gynecologic Oncology units equipped with a multidisciplinary team.
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