Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer An Age-Stratified Study of 1123 Women from the FRANCOGYN Group - Archive ouverte HAL Access content directly
Journal Articles Journal of Clinical Medicine Year : 2020

Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer An Age-Stratified Study of 1123 Women from the FRANCOGYN Group

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Sofiane Bendifallah
  • Function : Author
Camille Mimoun
  • Function : Author
Alexandre Bricou
  • Function : Author
Pierre Collinet
  • Function : Author
Cyril Touboul
  • Function : Author
Lobna Ouldamer
  • Function : Author
  • PersonId : 1077591
Henri Azaïs
Yohann Dabi
  • Function : Author
Cherif Akladios
  • Function : Author
Geoffroy Canlorbe
  • Function : Author
Pierre-Adrien Bolze
Mathieu Mezzadri
  • Function : Author
Tristan Gauthier
  • Function : Author
Frederic Kridelka
  • Function : Author
Pauline Chauvet
  • Function : Author
Nicolas Bourdel
  • Function : Author
Martin Koskas
  • Function : Author
Xavier Carcopino
  • Function : Author
Emilie Raimond
  • Function : Author
Olivier Graesslin
  • Function : Author
Lise Lecointre
  • Function : Author
Marcos Ballester
  • Function : Author
Cyrille Huchon

Abstract

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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hal-02860104 , version 1 (17-07-2020)

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Attribution - CC BY 4.0

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Yolaine Joueidi, Ludivine Dion, Sofiane Bendifallah, Camille Mimoun, Alexandre Bricou, et al.. Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer An Age-Stratified Study of 1123 Women from the FRANCOGYN Group. Journal of Clinical Medicine, 2020, 9 (5), ⟨10.3390/jcm9051451⟩. ⟨hal-02860104⟩
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