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Ovarian Cancer in the Elderly Time to Move towards a More Logical Approach to Improve Prognosis-A Study from the FRANCOGYN Group
- Source :
- Journal of Clinical Medicine, Journal of Clinical Medicine, 2020, 9 (5), ⟨10.3390/jcm9051339⟩, Journal of Clinical Medicine, MDPI, 2020, 9 (5), ⟨10.3390/jcm9051339⟩, Volume 9, Issue 5, Journal of Clinical Medicine, Vol 9, Iss 1339, p 1339 (2020)
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- Background and objective: Elderly and/or frail women with ovarian cancer are often undertreated. The aim of the study is to compare the effects of age and frailty on surgical approaches, postoperative complications, and prognosis in elderly women with ovarian cancer. Methods: A retrospective multicenter study of women &ge<br />70 years were treated for ovarian cancer at seven French university hospitals between 2007 and 2015. Results: Of the 1119 women treated for ovarian cancer during the study period, 147 were &ge<br />70 years and had complete data. Of these women, 65 were aged 70&ndash<br />74 years, and 82 were aged &ge<br />75 years. Overall, 77% of the younger women (49/65) received optimal treatment compared with 51% (40/82) of the older women (p = 0.018). Women &ge<br />75 years underwent fewer bowel resections (32% vs. 67%, p &lt<br />0.001) and experienced fewer postoperative complications (22.6% vs. 38.9%, p &lt<br />0.001)<br />53.2% of the women in this age group were treated by primary surgery or surgery only. These women also received more chemotherapy with platinum only (15% [9/56] vs. 2% [1/57], p = 0.007) and less bevacizumab (9% [5/56] vs. 32% [18/57], p = 0.003). Patients with greater frailty (a modified Charlson Comorbidity Index [mCCI] score &gt<br />3) had a five-year survival rate of 30% versus 62% for those with a score &le<br />3 (p &lt<br />0.001). Conclusions: Surgeons modify their approach to treating ovarian cancer in women &ge<br />75 years probably to reduce immediate postoperative complications. The prognosis is significantly worse in patients with greater frailty. Improvements to the sequence of treatments administered, with priority given to neoadjuvant chemotherapy in patients with greater frailty, could help increase the number of women who receive optimal treatment and improve their prognosis.
- Subjects :
- medicine.medical_specialty
endocrine system diseases
health care facilities, manpower, and services
medicine.medical_treatment
[SDV]Life Sciences [q-bio]
lcsh:Medicine
frailty
[SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics
chemotherapy
elderly
Article
surgery
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
In patient
Survival rate
Chemotherapy
030219 obstetrics & reproductive medicine
Surgical approach
business.industry
lcsh:R
Logical approach
social sciences
General Medicine
University hospital
medicine.disease
humanities
3. Good health
ovarian cancer
Multicenter study
030220 oncology & carcinogenesis
business
Ovarian cancer
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine, Journal of Clinical Medicine, 2020, 9 (5), ⟨10.3390/jcm9051339⟩, Journal of Clinical Medicine, MDPI, 2020, 9 (5), ⟨10.3390/jcm9051339⟩, Volume 9, Issue 5, Journal of Clinical Medicine, Vol 9, Iss 1339, p 1339 (2020)
- Accession number :
- edsair.doi.dedup.....edf8698a0e2fcce134523fcabb0aba3a