Incidence, treatment, and survival trends in older versus younger women with epithelial ovarian cancer from 2005 to 2018: A nationwide Danish study

Ekmann-Gade, Anne Weng; Høgdall, Claus; Seibæk, Lene; Noer, Mette Calundann; Fagö-Olsen, Carsten Lindberg; Schnack, Tine Henrichsen

doi:10.1016/j.ygyno.2021.10.081

Cited by 10 publications

(7 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous findings, one out of two older women with advanced-stage EOC did not undergo PDS or IDS [3]. Patients with NDS had higher age and worse PS at diagnosis than those undergoing debulking surgery.…”

Section: Discussionsupporting

confidence: 89%

“…Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy for which long-term survival is conditioned by surgery often combined with chemotherapy [1,2]. The balance between performing this comprehensive treatment combination and the EOC patient population, with a considerable number of older women, poses a continuous challenge in a clinical setting [3]. Older patients with EOC repeatedly demonstrate poor survival compared to younger [4].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, while inherent patient factors contribute to decreased survival, there is likely an effect related to differences in the patterns of care too. Almost half of EOC cases occur in patients ≥70 years, which is projected to increase [3]. As older patients seem to desire full treatment and disease cure as strongly as the young and do not regard their age as a barrier, challenges in clinical management should be scientifically prioritized [6,7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of surgery and chemotherapy timing on outcomes in older versus younger epithelial ovarian cancer patients: A nationwide Danish cohort study

Ekmann-Gade

Schnack²,

Seibæk³

et al. 2023

Journal of Geriatric Oncology

Self Cite

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of surgery and chemotherapy timing on outcomes in older versus younger epithelial ovarian cancer patients: A nationwide Danish cohort study

Ekmann-Gade

Schnack²,

Seibæk³

et al. 2023

Journal of Geriatric Oncology

Self Cite

View full text Add to dashboard Cite

“…A larger tumor burden was associated with a greater tumor burden, which we believe is closely related to the FIGO stage of the disease; thus, future studies could subdivide stages IA and IB. Previous studies have suggested that age is a high-risk factor for a prognosis for EOC, and some studies have suggested that age ≥ 70 years is associated with a 1.4-fold increased risk of CSS [15]. Our results showed that those who were < 50 years old had a worse prognosis, which may be related to the trend of younger onset of OCCC and the faster disease progression in younger patients compared with older patients.…”

Section: Discussionmentioning

confidence: 44%

Construction of a prediction model of cancer-specific survival after ovarian clear cell carcinoma surgery

Huang¹,

Li²,

Liu³

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose To construct a nomogram model for predicting postoperative cancer-specific survival (CSS) of patients with ovarian clear cell carcinoma (OCCC) and analyze in detail the risk factors associated with OCCC. Methods The clinical pathological data of 596 OCCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. Of these patients, 420 were allocated to the training group and 176 patients to the validation group using bootstrap resampling. The nomogram was developed based on the Cox regression model for predicting the cancer-specific survival probability of patients at 3 and 5 years after the operation. The model was evaluated in both the training and validation groups using consistency index, Receiver Operating Characteristic (ROC), and calibration plots. Results The independent risk factors for CSS in OCCC patients included FIGO stage, race, age, tumor laterality, and the log odds of positive lymph nodes (LODDS). The nomograms were established for predicting the 3- and 5-year CSS of patients after operation. The c-index of the nomogram for CSS was 0.786 in the training group and 0.742 in the verification group. AUCs of the 3-year and 5-year ROC curves were 0.818, 0.824 in the training group; and 0.816, 0.808 in the verification group, respectively. Conclusion Based on the real population data, the construction of the CSS prediction model after OCCC surgery has high prediction efficiency, can identify postoperative high-risk OCCC patients, and can be a valuable aid for the tumor staging system.

show abstract

“…However, the lack of data specific to older patients, seldom included or highly selected in pivotal trials, 5 – 8 and the fear of excessive toxicity, 9 may explain these inequalities. Furthermore, treatment strategies for older patients are based on subgroup analyses of pivotal randomized trials, 10 , 11 prospective real-life unselected population-based studies, 12 – 14 retrospective studies, 15 and specific clinical trials conducted in older patients, 16 , 17 but these seldom integrate assessment of geriatric covariates. In this context, it appears useful to describe the available evidence on cancer characteristics at diagnosis in older patients, the general impact of age on outcomes, and all successive treatment steps.…”

Section: Introductionmentioning

confidence: 99%

Ovarian cancer in the older patient: where are we now? What to do next?

Rousseau,

Ranchon,

Bardin

et al. 2023

Ther Adv Med Oncol

View full text Add to dashboard Cite

In recent years, major advances have been made toward the individualization of epithelial ovarian cancer care, leading to an overall improvement of patient outcomes. However, real-life data indicate that the oldest populations do not benefit from this, due to aspects related to cancer (more aggressive histopathological features), treatment (i.e. frequently suboptimal), and the host (increased toxicities in patients with lower physiological reserve). A specific risk–benefit perspective should therefore be taken when considering surgery, chemotherapy, and maintenance treatments: the decision for cytoreductive surgery should include geriatric vulnerability and surgical complexity, neo-adjuvant chemotherapy being an option when primary surgery appears at high risk; carboplatin paclitaxel association remains the standard even in vulnerable older patients; and bevacizumab and poly(ADP-ribose) polymerase inhibitors maintenance are interesting options provided they are prescribed according to their indications with a close monitoring of their toxicities. Future studies should aim to individualize care without limiting access of older patients to innovation. A specific focus is needed on age-specific translational analyses (focusing on tumor mutational burden and impaired biological pathways), a better patient stratification according to geriatric parameters, an adaptation of both oncological treatment and geriatric interventions, and treatment adaptations not a priori but according to formal pharmacokinetic data.

show abstract

Incidence, treatment, and survival trends in older versus younger women with epithelial ovarian cancer from 2005 to 2018: A nationwide Danish study

Cited by 10 publications

References 34 publications

Impact of surgery and chemotherapy timing on outcomes in older versus younger epithelial ovarian cancer patients: A nationwide Danish cohort study

Impact of surgery and chemotherapy timing on outcomes in older versus younger epithelial ovarian cancer patients: A nationwide Danish cohort study

Construction of a prediction model of cancer-specific survival after ovarian clear cell carcinoma surgery

Ovarian cancer in the older patient: where are we now? What to do next?

Contact Info

Product

Resources

About