Age‑related differences in prognosis and prognostic factors among patients with epithelial ovarian cancer

Abstract

Approximately 40% of all patients with ovarian cancer in Japan are aged ≥65 years. The aim of the present study was to evaluate the differences in prognosis and prognostic factors between elderly and younger patients with epithelial ovarian cancer. A total of 114 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-IV ovarian cancer who were initiated on primary treatment at the Osaka City University Hospital (Osaka, Japan) were included in this study. Patient characteristics, treatment outcome and prognosis were compared between elderly (aged ≥65 years) and younger patients, and the prognostic factors associated with overall survival were evaluated by univariate and multivariate analyses. The most common histological type in younger patients was clear cell carcinoma (33.8%) vs. serous carcinoma in elderly patients (44.1%), with a significant difference in the distribution of histological type (P=0.006). Complete resection was achieved in 56.2% of younger patients compared with 32.4% of elderly patients (P=0.03). The rates of standard primary treatment were comparable (56.7% of younger vs. 50.0% of elderly patients). Overall and disease-free survival did not differ significantly between the two groups. Multivariate analyses identified FIGO stage and standard primary therapy as prognostic factors in younger patients and performance status in elderly patients. Age was not an independent significant prognostic factor among patients with ovarian cancer. Therefore, performance status, rather than age, should be considered when selecting the optimal treatment for elderly patients based on objective assessment.

Conditional disease‐free survival rates and their associated determinants in patients with epithelial ovarian cancer: A 15‐year retrospective cohort study

“…Different prognostic factors have been mentioned in younger and elderly patients in a previous study. The FIGO stage and standard primary treatment were independent determinants in younger women, whereas performance status was identified as the independent determinant in elderly women 22 . On the other hand, another study showed higher survival rates for very young EOC patients compared to young or older groups 23 .…”

“…The FIGO stage and standard primary treatment were independent determinants in younger women, whereas performance status was identified as the independent determinant in elderly women. 22 On the other hand, another study showed higher survival rates for very young EOC patients compared to young or older groups. 23 This result might be related to the medical and physiological conditions which might be present in older EOC patients and require special attention in planning treatment.…”

“…However, a previous study demonstrated that the mortality and morbidity percentages were the same across younger and older patients who were equally debulked 27 . Another study also found that age was not an independent prognostic factor for either OS or DFS among EOC women and performance status affected the treatment outcome for elderly patients 22 . In general, there is still controversy about the prognostic effect of age in EOC women.…”

“… 27 Another study also found that age was not an independent prognostic factor for either OS or DFS among EOC women and performance status affected the treatment outcome for elderly patients. 22 In general, there is still controversy about the prognostic effect of age in EOC women.…”

Survival Analysis of Ovarian Cancer Patients based on Age at The Dr. Wahidin Sudirohusodo Makassar Hospital in 2014-2018

“…18 However, the high heterogeneity of elderly patients means that it is not feasible to make treatment decisions based on age alone, and a more objective assessment is required. 19 Weaknesses in this study are that researchers cannot control the state and quality of data that have been done by others in the past and the research can only rely on secondary data that is already in incomplete medical record records where the possibility of errors in recording or available data is not appropriate with what is needed in research. For this reason, better records are needed for ovarian cancer patients.…”