OBJECTIVES: With the rising mean age, more patients will have one or more other serious diseases at the time of diagnosis of ovarian cancer (co-morbidity). In this study, the independent effects of age and co-morbidity on the application of treatment guidelines and prognosis were evaluated. METHODS: All patients with epithelial ovarian cancer diagnosed between 1995 and 2001 in the southern part of The Netherlands (N = 1116) were included. RESULTS: The prevalence of co-morbidity increased from 34% of the age group <70 to 63% of the older age group. Eighty-three percent of the patients with FIGO stage II or stage III younger than 70 years underwent the advised treatment (combination of surgery and chemotherapy) compared to only 45% of the patients aged 70 or older. In a multivariable analysis age, FIGO stage, presence of co-morbidity, and year of diagnosis seemed to be independent predictors of receiving the advised treatment. In multivariable analyses age 70 + (HR = 1.3, 95% CI = 1.03-1.7) and the use of both surgery and chemotherapy (HR = 0.4, 95% CI = 0.3-0.6, reference is only surgery) were independent prognostic factors for overall survival. CONCLUSIONS: Even in the absence of co-morbidity, standard combination therapy was prescribed significantly less often for elderly patients with FIGO II or III ovarian cancer. Age and combined treatment of surgery and platinum-based chemotherapy were independent prognostic factors. Co-morbidity did not seem to have a prognostic effect.
OBJECTIVES: With the rising mean age, more patients will have one or more other serious diseases at the time of diagnosis of ovarian cancer (co-morbidity). In this study, the independent effects of age and co-morbidity on the application of treatment guidelines and prognosis were evaluated. METHODS: All patients with epithelial ovarian cancer diagnosed between 1995 and 2001 in the southern part of The Netherlands (N = 1116) were included. RESULTS: The prevalence of co-morbidity increased from 34% of the age group <70 to 63% of the older age group. Eighty-three percent of the patients with FIGO stage II or stage III younger than 70 years underwent the advised treatment (combination of surgery and chemotherapy) compared to only 45% of the patients aged 70 or older. In a multivariable analysis age, FIGO stage, presence of co-morbidity, and year of diagnosis seemed to be independent predictors of receiving the advised treatment. In multivariable analyses age 70 + (HR = 1.3, 95% CI = 1.03-1.7) and the use of both surgery and chemotherapy (HR = 0.4, 95% CI = 0.3-0.6, reference is only surgery) were independent prognostic factors for overall survival. CONCLUSIONS: Even in the absence of co-morbidity, standard combination therapy was prescribed significantly less often for elderly patients with FIGO II or III ovarian cancer. Age and combined treatment of surgery and platinum-based chemotherapy were independent prognostic factors. Co-morbidity did not seem to have a prognostic effect.
Authors: Casey M Hay; Heidi S Donovan; Grace B Campbell; Sarah E Taylor; Li Wang; Madeleine Courtney-Brooks Journal: Gynecol Oncol Date: 2018-11-28 Impact factor: 5.482
Authors: Albina N Minlikeeva; Jo L Freudenheim; Rikki A Cannioto; J Brian Szender; Kevin H Eng; Francesmary Modugno; Roberta B Ness; Michael J LaMonte; Grace Friel; Brahm H Segal; Kunle Odunsi; Paul Mayor; Emese Zsiros; Barbara Schmalfeldt; Rüdiger Klapdor; Thilo Dӧrk; Peter Hillemanns; Linda E Kelemen; Martin Kӧbel; Helen Steed; Anna de Fazio; Susan J Jordan; Christina M Nagle; Harvey A Risch; Mary Anne Rossing; Jennifer A Doherty; Marc T Goodman; Robert Edwards; Keitaro Matsuo; Mika Mizuno; Beth Y Karlan; Susanne K Kjær; Estrid Høgdall; Allan Jensen; Joellen M Schildkraut; Kathryn L Terry; Daniel W Cramer; Elisa V Bandera; Lisa E Paddock; Lambertus A Kiemeney; Leon F Massuger; Jolanta Kupryjanczyk; Andrew Berchuck; Jenny Chang-Claude; Brenda Diergaarde; Penelope M Webb; Kirsten B Moysich Journal: Cancer Causes Control Date: 2017-03-14 Impact factor: 2.506
Authors: Eileen H Shinn; Daniel J Lenihan; Diana L Urbauer; Karen M Basen-Engquist; Alan Valentine; Laura Palmero; Myrshia L Woods; Pooja Patel; Alpa M Nick; Mian M K Shahzad; Rebecca L Stone; Antoinette Golden; Emma Atkinson; Susan K Lutgendorf; Anil K Sood Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-09-17 Impact factor: 4.254
Authors: Bethany B Barone; Hsin-Chieh Yeh; Claire F Snyder; Kimberly S Peairs; Kelly B Stein; Rachel L Derr; Antonio C Wolff; Frederick L Brancati Journal: JAMA Date: 2008-12-17 Impact factor: 56.272
Authors: Charlotte E Joslin; Katherine C Brewer; Faith G Davis; Kent Hoskins; Caryn E Peterson; Heather A Pauls Journal: Gynecol Oncol Date: 2014-08-28 Impact factor: 5.482