Age as a prognostic factor in epithelial ovarian carcinoma

Abstract

Summary. One prognostic factor in epithelial ovarian cancer appears to be the patient's age at presentation. We have retrospectively analysed data from 2305 patients with this tumour in East Anglia during the period 1960–1980. The influence of age as a factor in survival was studied by comparing outcome in young patients between the ages of 15 and 35 (3.1% of all cases) with the outcome in the women over 35. The prognosis was significantly better in young patients, even when age correction is applied. This has implications for the management of patients with this common tumour.

Ovarian cancer in younger vs older women: a population-based analysis

“…However, studies on the prognostic implications of age and ovarian cancer are inconclusive. Although most reports have shown that younger women with ovarian cancer have an improved outcome compared to older women and have lower stage and more well-differentiated tumours (Smedley and Sikora, 1985;Plaxe et al, 1993;Thigpen et al, 1993;Rodriguez et al, 1994;Chan et al, 2003), others have found that age is not an independent prognostic factor after adjusting for tumour stage and grade (Massi et al, 1996;Duska et al, 1999). Moreover, the majority of these previous studies on ovarian cancer are based on single institution experiences, which contain inherent biases such as patient selection (Plaxe et al, 1993;Duska et al, 1999;Chan et al, 2003).…”

“…In addition, owing to the low prevalence of young patients diagnosed with invasive ovarian cancer, these studies have also been limited by a small number of patients, inclusion of low malignant potential tumours, germ cell or sex cord stromal tumours, and unstaged cancers. European analyses on ovarian cancer incidence rates include studies carried out by Smedley and Sikora (1985), La Vecchia et al (1992), dos Santos Silva and Swerdlow (1995), Koper et al (1996), Nelson et al (1999). Given the limitations from prior reports, we proposed to perform a large population-based study to evaluate the clinico-pathologic characteristics between younger and older patients with epithelial ovarian cancer.…”

“…Despite advances in surgical and systemic treatment, the 5-year survival of advanced stage patients with ovarian cancer remains below 30% (Nguyen et al, 1993;Parker et al, 1996;Jemal et al, 2004;Ries et al, 2004). However, invasive epithelial ovarian cancer is largely a disease of postmenopausal women with reproductive-age women comprising only 20% of all patients (Smedley and Sikora, 1985;Swenerton et al, 1985;Plaxe et al, 1993;Rodriguez et al, 1994). Previous studies on young patients with ovarian cancer have reported survival rates as high as 75% across all stages compared to 40% in the overall population.…”

“…Nonetheless, several other published studies have specified age as a significant prognostic factor, with older patients faring less well than younger women (Smedley and Sikora, 1985;Swenerton et al, 1985;Yancik et al, 1986;Omura et al, 1991;Gloecker-Ries, 1993;Thigpen et al, 1993;Kosary, 1994;Rodriguez et al, 1994;Lee et al, 1999;Brun et al, 2000;Schildkraut et al, 2000;Barnholtz-Sloan et al, 2003;Chan et al, 2003;O'Malley et al, 2003).…”

Fertility preservation in patients with early epithelial ovarian cancer

“…Several reports have estimated that 3-17% of all EOCs occur in women under 40 years of age. [3][4][5][6][7] In these patients, the preservation of the reproductive and endocrine functions is crucial. Therefore, fertility-sparing surgery has figured prominently in the consideration of appropriate gynecologic malignancy treatment.…”