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

被引：18

作者：

Joueidi, Yolaine ^{[1
]}

Dion, Ludivine ^{[1
,2
]}

Bendifallah, Sofiane ^{[3
]}

Mimoun, Camille ^{[4
]}

Bricou, Alexandre ^{[5
,6
]}

Timoh, Krystel Nyangoh ^{[1
]}

Collinet, Pierre ^{[6
]}

Touboul, Cyril ^{[3
]}

Ouldamer, Lobna ^{[7
]}

Azais, Henri ^{[8
]}

Dabi, Yohann ^{[9
]}

Akladios, Cherif ^{[10
]}

Canlorbe, Geoffroy ^{[8
]}

Bolze, Pierre-Adrien ^{[11
]}

Costaz, Helene ^{[12
]}

Mezzadri, Mathieu ^{[13
]}

Gauthier, Tristan ^{[14
]}

Kridelka, Frederic ^{[15
]}

Chauvet, Pauline ^{[16
]}

Bourdel, Nicolas ^{[16
]}

Koskas, Martin ^{[17
]}

Carcopino, Xavier ^{[18
]}

Raimond, Emilie ^{[19
]}

Graesslin, Olivier ^{[19
]}

Lecointre, Lise ^{[10
]}

Ballester, Marcos ^{[5
]}

Huchon, Cyrille ^{[20
]}

Leveque, Jean ^{[1
,2
]}

Lavoue, Vincent ^{[1
,2
]}

机构：

[1] Hop Sud, Rennes Univ Hosp, Dept Gynecol, F-35000 Rennes, France

[2] IRSET, INSERM, Equipe 8, U1085, F-35000 Rennes, France

[3] Hop Tenon, AP HP, Serv Gynecol, F-75020 Paris, France

[4] Lariboisiere Hosp, Dept Gynecol & Obstet, F-75010 Paris, France

[5] Croix St Simon, Serv Chirurg Gynecol, F-75000 Paris, France

[6] Hop Jeanne Flandres, Serv Gynecol, F-59000 Lille, France

[7] CHU Tours, Serv Gynecol, F-37000 Tours, France

[8] Pitie Salpetriere Univ Hosp, AP HP, Dept Gynecol & Breast Surg & Oncol, F-75013 Paris, France

[9] Ctr Hosp Inter Communal Creteil, Serv Gynecol Obstet, F-94000 Creteil, France

[10] CHU Hautepierre, Serv Gynecol Obstet, F-67000 Strasbourg, France

[11] CHU Lyon Sud, Hosp Civils Lyon, Serv Gynecol Obstet, F-69000 Lyon, France

[12] Ctr Georges Francois Leclerc, UNICANC, Dept Oncol Chirurg, F-21000 Dijon, France

[13] Hop Lariboisiere, AP HP, Serv Gynecol Obstet, F-75000 Paris, France

[14] CHU Limoges, Serv Gynecol Obstet, F-87000 Limoges, France

[15] Serv Chirurg Oncol & Gynecol, B-4000 Liege, Belgium

[16] CHU Clermont Ferrand, Serv Gynecol Obstet, F-63000 Clermont Ferrand, France

[17] Hop Bichat Claude Bernard, AP HP, Serv Gynecol, F-75018 Paris, France

[18] Hop La Timone, AP HM, Serv Gynecol, F-13000 Marseille, France

[19] Hop Univ Reims, Serv Gynecol, F-51000 Reims, France

[20] Ctr Hosp Poissy, Dept Gynecol, F-78000 Poissy, France

来源：

JOURNAL OF CLINICAL MEDICINE | 2020年 / 9卷 / 05期

关键词：

ovarian cancer; elderly; surgery; chemotherapy; frailty; STAGE-IV OVARIAN; OLDER WOMEN; GREATER-THAN-OR-EQUAL-TO-70; YEARS; CYTOREDUCTIVE SURGERY; PROGNOSTIC-FACTOR; CHEMOTHERAPY; OUTCOMES; CARE; PATTERNS; CLASSIFICATION;

D O I：

10.3390/jcm9051451

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页数：14

共 56 条

[1]

ALBERTS DS, 1993, CANCER-AM CANCER SOC, V71, P618

[2] Relationship among surgical complexity, short-term morbidity, and overall survival in primary surgery for advanced ovarian cancer [J].