Ovarian Cancer Management in the Oldest Old: Improving Outcomes and Tailoring Treatments

Abstract

Ovarian cancer is the most common cause of death from gynecological cancers in developed countries. It is a common disease of older women at or above 63 years upon diagnosis. Thanks to advance in new treatments, mortality from ovarian cancer has declined in developed countries in the last decade. This decline in mortality rate is unevenly distributed across the age-spectrum. While mortality in younger women has decreased 21.7%, for elderly women it has declined only 2.2%. Even if ovarian cancer is clearly a disease of the elderly, older women are underrepresented in clinical trials, and scant evidence exists for the treatment of women older than 80 years. Moreover, older women are frequently undertreated, receive less chemotherapy and less combination of surgery and chemotherapy, despite the fact that this is considered the optimal treatment modality. This may be mainly due to the lack of evidence and physician’s confidence in the management of elderly women with ovarian cancer. In this review, we focus on the management of older women with ovarian cancer, considering geriatric features tied to this population.

Retrospective analysis of the efficacy of adjuvant CIK cell therapy in epithelial ovarian cancer patients who received postoperative chemotherapy

“…The incidence rate of EOC increases with age. Our data together with others' studies showed that advanced age in patients with EOC was associated with short survival duration.- 30,31 Furthermore, in the subgroup analyses, adjuvant CIT was found to be significantly associated with an improved overall survival rate in patients more than 45 years old, but this association was absent in EOC patients who were under the age of 45. This improvement or lack thereof may be explained by the fact that immune alteration is age dependent.…”

“…While mortality in younger women has decreased by 21.7%, said figure was only 2.2% lower for elderly women. 31 Our results revealed that adjuvant CIT achieved favorable clinical outcomes for older patients, suggesting its effectiveness as a treatment for older EOC patients.…”

“…32 Decreased antitumor immunity in elderly patients may be associated with the general decline in the performance of immune cells, since aging may severely affect chemokine production and the physical condition of immune cells. 31,33 On a further note, thanks to advancement in new treatments, mortality caused by ovarian cancer has declined in the last decade. However, the decline in mortality rate is unevenly distributed across the age spectrum.…”

The Response of Second Line Chemotherapy Platinum Resistant Ovarian Cancer in Sudan: 2013-2017

“…The lifetime risk of developing ovarian cancer in general population is 1.4 per cent and the mean age of presentation is 64 years, even though his incidence are varied by regions (7). Many factors play major role in the disease development and these includes advance age (8,9), genetics associations (10)(11)(12), early menstruation (13), late menopausal age (14) and hormonal therapy (15). An ovarian tumor mainly originates from its own tissue but some multiple tumors such as colon (16), stomach (17), small intestine (18), pancreas (6), breast (19) and even thyroid cancer (20) can be metastasis to the ovary.…”

The Response of Second Line Chemotherapy Platinum Resistant Ovarian Cancer in Sudan: 2013-2017

“…The lifetime risk of developing ovarian cancer in general population is 1.4 per cent and the mean age of presentation is 64 years, even though its incidence are varied by regions (7). Many factors play major role in the disease development and these includes advance age (8,9), genetics associations (10)(11)(12), early menstruation (13), late menopause (14) and hormonal therapy (15). An ovarian tumors are mainly primary but secondaries from colon (16), stomach (17), small intestine (18), pancreas (6), breast (19) and even thyroid cancer (20) are also common.…”