Prognostic Factors for Ovarian Epithelial Cancer in the Elderly

Sabatier, Renaud; Calderon, Benoît; Lambaudie, Éric; Chéreau, E.; Provansal, Magali; Cappiello, Maria-Antonietta; Viens, Patrice; Rousseau, Frédérique

doi:10.1097/igc.0000000000000418

Cited by 33 publications

(35 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 A recent case-control study, including patients aged 70 years or older and younger cases, showed that younger patients have a significantly longer median OS (65.2 vs 26.2 months). 6 Conversely, a prospective analysis of the ovarian cancer diagnosis consortium concluded that women aged 70 years or older were less likely to receive an optimal treatment compared with younger women, and their outcome was less favorable. However, age lost its prognostic relevance at multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Ovarian Cancer in Elderly Patients: Patterns of Care and Treatment Outcomes According to Age and Modified Frailty Index

Ferrero¹,

Fuso²,

Tripodi³

et al. 2017

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Ovarian Cancer in Elderly Patients: Patterns of Care and Treatment Outcomes According to Age and Modified Frailty Index

Ferrero¹,

Fuso²,

Tripodi³

et al. 2017

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…The effect of the expression of the immune markers on OS was expressed using hazard ratios (HRs) with 95% confidence interval (CI), estimated using univariable and multivariable Cox regression. The multivariable analysis adjusted for clinical factors known to influence HGSC survival, age at diagnosis (≥ 70 vs. < 70), stage (IV vs. III), and residual tumor following primary cytoreductive surgery (macroscopic residual tumor vs. no) [1,26,27], were analyzed as binary factors. All P values are two sided.…”

Section: Statistical Analysesmentioning

confidence: 99%

PD-1/PD-L1 expression and tumor-infiltrating lymphocytes are prognostically favorable in advanced high-grade serous ovarian carcinoma

et al. 2020

View full text Add to dashboard Cite

The response rate to checkpoint inhibitors for women with high-grade serous carcinoma of the ovary, fallopian tube, and peritoneum (HGSC) is modest, and development of predictive biomarkers is needed. The main focus has been on tumor cell PD-L1 expression, but its assessment alone is insufficient for patient selection in most malignancies. We mapped the presence of macrophages (CD68 and CD163) and lymphocytes (CD3) located within the tumor epithelium, the cell type-specific expression of PD-L1 and PD-1, and their impact on 5-year overall survival (OS) in a consecutive cohort of 130 women diagnosed with advanced HGSC between 2011 and 2015. PD-L1 was expressed mainly by macrophages (not by tumor cells) and PD-1 by lymphocytes. Women with higher CD3, PD-L1, and PD-1 expression had improved OS (P = 0.03, P = 0.007, and P = 0.02, respectively). In the external data set (203 women), high expression of CD274 (encoding PD-L1) was associated with improved OS (P = 0.03), in accordance with our results. Furthermore, higher CD163 expression was associated with better outcome in women with no residual tumor after primary surgery (P = 0.02). Thus, women with greater lymphocyte tumor infiltration had better outcome and PD-L1/PD-1 expression, regardless of PD-1/PD-L1 being markers for immune suppressive pathways, conferred a survival benefit in our cohort. Our results highlight that tumor immunity may be harnessed in subsets of HGSC.

show abstract

“…Several observational studies have shown that elderly ovarian carcinoma patients receive standard treatment less frequently than their younger counterparts. This applies to both chemotherapy and CRS [3,[7][8][9][10][11]. Older patients less often have complete surgery [10] and suffer more frequently from postoperative complications and mortality [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…This applies to both chemotherapy and CRS [3,[7][8][9][10][11]. Older patients less often have complete surgery [10] and suffer more frequently from postoperative complications and mortality [12][13][14]. A Dutch single-centre cohort study [15] found that 11 out of 47 patients (23%) aged 70 years or older who were considered fit for standard treatment, were not able to complete treatment without adjustments.…”

Section: Introductionmentioning

confidence: 99%

GERiatric Screening in the treatment of elderly patients with Ovarian Carcinoma (GERSOC): study protocol for a pragmatic, cluster randomised controlled trial

Soolingen

Smorenburg

Hamaker

et al. 2020

Trials

View full text Add to dashboard Cite

Background: Approximately 40% of the newly diagnosed patients with advanced ovarian cancer are aged 70 years or older. Standard treatment for advanced disease consists of cytoreductive surgery and combination chemotherapy. In older patients, standard treatment is often withheld or prematurely stopped due to suspected frailty. It remains challenging to distinguish fit elderly patients who can endure standard therapy from frail patients who may benefit from an adapted treatment strategy. As a comprehensive geriatric assessment (CGA) can contribute to the identification of frail patients and improve tailored therapy in this population, screening tests were developed to select those who may benefit from a CGA. However, the use of these geriatric screening tests has rarely been compared with usual clinical care. The GERSOC-trial will evaluate whether geriatric screening in elderly patients with advanced-stage ovarian cancer improves treatment completion and quality of life. Methods: This pragmatic, cluster randomised controlled trial will be conducted at a minimum of 20 hospitals in the Netherlands. Hospitals are randomly assigned to geriatric screening care (in which a geriatric screening comprised of the G8 questionnaire and the Timed Up and Go test is performed), or care as usual (in which current usual care is continued). A total of 320 patients aged ≥ 70 years with primary, advanced-stage ovarian carcinoma will be included. Patients considered fit on geriatric screening will receive standard treatment; patients who are considered unfit will be referred to a geriatrician for analysis and treatment advice. The primary outcome is the percentage difference in completed standard and adapted therapies between the two study arms. Secondary outcomes include quality of life, cost-effectiveness and survival. Discussion: This trial aims to gather evidence for the use of geriatric screening in treatment decision-making in elderly patients with advanced ovarian cancer. If proven feasible, beneficial and cost-effective, geriatric screening may be implemented in routine clinical practice.

show abstract

Prognostic Factors for Ovarian Epithelial Cancer in the Elderly

Cited by 33 publications

References 40 publications

Ovarian Cancer in Elderly Patients: Patterns of Care and Treatment Outcomes According to Age and Modified Frailty Index

Ovarian Cancer in Elderly Patients: Patterns of Care and Treatment Outcomes According to Age and Modified Frailty Index

PD-1/PD-L1 expression and tumor-infiltrating lymphocytes are prognostically favorable in advanced high-grade serous ovarian carcinoma

GERiatric Screening in the treatment of elderly patients with Ovarian Carcinoma (GERSOC): study protocol for a pragmatic, cluster randomised controlled trial

Contact Info

Product

Resources

About