Epithelial Ovarian Cancer in Older Women: Defining the Best Management Approach

Abstract

Epithelial ovarian cancer is a cancer of older women. In fact, almost half of women diagnosed with ovarian cancer will be older than age 64, and 25% will be older than age 74. Therefore, it is crucial to examine the available data in older populations to optimize the therapeutic approach without negatively affecting the quality of life permanently. Unfortunately, little prospective data are available in this under-represented population of women. Although ovarian cancer traditionally has been approached with aggressive cytoreductive surgery, older patients may benefit from a less aggressive surgical approach and, in some cases, may be candidates for neoadjuvant chemotherapy followed by an interval cytoreduction. Modalities do exist for assessing an older woman's ability to tolerate surgery and chemotherapy, and these tools should be familiar to clinicians who are caring for this population of women in making treatment decisions. Ongoing planned trials to evaluate pretreatment assessment for older patients will provide objective, feasible, clinical tools for applying our treatment-based knowledge. Future trials of both surgery and chemotherapy, including a focus on the sequence of these two treatment modalities, are crucial to guide decision making in this vulnerable population and to improve outcomes for all.

OSov: An Interactive Web Server to Evaluate Prognostic Biomarkers for Ovarian Cancer

“…The risk factors were from the clinical data and long-term follow-up information. The clinicopathological features returned contained many factors based on previous studies [ 5 , 6 , 7 , 8 ], such as age, histological type, etc. Age is a worse predictor in ovarian cancer development and survival [ 7 ].…”

“…The clinicopathological features returned contained many factors based on previous studies [ 5 , 6 , 7 , 8 ], such as age, histological type, etc. Age is a worse predictor in ovarian cancer development and survival [ 7 ]. Histology is another key risk factor in estimating clinical outcome and clinical management, including serous, clear cells, mucinous, etc.…”

Trends in gynecological cancer incidence, mortality, and survival among elderly women: A SEER study

“…Advancing age is a major risk factor for cancer, with individuals over 65 years accounting for 60% of newly diagnosed malignancies and 70% of all cancer deaths (Berger et al., 2006) 7,8 . Elderly women are frequently diagnosed at later stages and experience worse outcomes than younger patients 9,10 . Consequently, there may be an unmet need among older women in terms of gynecological cancer prevention and treatment 11 …”

A 16-year-old with borderline mucinous tumor of the left ovary

“…Ovarian mucinous tumors are epithelial neoplasms seen commonly in the third to sixth decade of life. 2 Ovarian mucinous tumors can be classified into 3 categories based on histopathology (benign, borderline malignant, malignant). Ovarian mucinous cystadenomas of borderline malignancy in adolescents are exceedingly rare.…”