Poor outcome of elderly patients with platinum-sensitive recurrent ovarian cancer: Results from the SOCRATES retrospective study

Pignata, Sandro; Ferrandina, Gabriella; Scarfone, Giovanna; Scollo, Paolo; Odicino, Franco; Cormio, Gennaro; Katsaros, Dionyssios; Frigerio, Luigi; Mereu, Liliana; Ghezzi, Fabio; Manzione, Luigi; Lauria, Rossella; Breda, Enrico; Alletti, Desiderio Gueli; Ballardini, Michela; Vernaglia, Alessandra; Sorio, Roberto; Tumolo, Salvatore; Musso, Pietro; Magni, Giovanna; Pisano, Carmela; Morabito, Alessandro

doi:10.1016/j.critrevonc.2008.12.010

Cited by 31 publications

(17 citation statements)

References 38 publications

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“…The results from the SOCRATES retrospective study indicate that the mean number of chemotherapy lines received for ovarian cancer recurrence was 2.7 and 2.5 in young (<70 years) and aged patients (≥70 years), respectively (nonsignificant), with elderly patients receiving more frequently single-agent platinum instead of platinum combination therapy or other nonplatinum chemotherapy as second-line treatment. The response rate (complete response + partial response) to second-line chemotherapy was higher in younger patients (67.2%) than in the elderly population (46.5%; p = 0.0004), thus stressing that age is an unfavorable independent prognostic factor [11]. A French group reported its experience in 83 elderly patients (aged >70 years) affected by advanced ovarian cancer and treated with a combination of carboplatin and cyclophosphamide, showing the feasibility of the treatment in this cluster of patients [14].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of clinicians seem to be unprepared to treat elderly patients, and many data indicate that a great number of patients are undertreated for fear of unacceptable side effects, thus limiting their possibility of cure and survival improvement. It has been demonstrated that elderly patients affected by ovarian carcinoma have a poorer prognosis compared with their younger counterpart, and in most cases this can be ascribed to undertreatment [11]. Thus, the management of cancer in old patients represents a priority for health care delivery in the immediate future [5].…”

Section: Discussionmentioning

confidence: 99%

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Chemotherapy in Elderly Patients with Gynecological Cancer

Palaia¹,

Loprete²,

Musella³

et al. 2013

Oncology

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Objective: The aim of this study was to determine the tolerability, safety and feasibility of chemotherapy in very elderly patients with gynecological cancers. Methods: We included all patients ≥75 years of age affected by endometrial, ovarian or cervical cancer treated with neoadjuvant, adjuvant or palliative chemotherapy. Data regarding age, stage of the disease, comorbidities, performance status (PS), chemotherapy regimen and dosing, toxicity, treatment delay and dose adjustments were recorded. Results: Forty-nine patients were included in the study. Their median age was 77.5 years. The vast majority of patients (89.8%) presented with advanced neoplastic disease. Twenty-nine of the 49 patients were treated with full-dose chemotherapy; 41% were subjected to the weekly dose. One toxic death was recorded; grade 2 anemia was reported in 8 patients, and grade 2 and 3 neutropenia was recorded in 2 and 3 patients, respectively. Sixty-one percent of the patients completed the planned treatment. Conclusion: Chemotherapy in very elderly patients is feasible with an acceptable toxicity profile. Careful evaluation of PS and assessment of physical and psychological health are necessary to predict tolerability of chemotherapy. A weekly schedule is better tolerated in this setting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chemotherapy in Elderly Patients with Gynecological Cancer

Palaia¹,

Loprete²,

Musella³

et al. 2013

Oncology

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“…19 Previously reported adverse prognostic factors in women with ovarian cancer include stage, age, performance status, tumour histology and residual tumour volume following cytoreduction. 17,21,22 Although ovarian cancer sometimes metastasises to extra-abdominal sites such as lung, 23 brain [24][25][26] and bone 27,28 the most important co-morbidity of ovarian cancer relates to bowel compromise. [29][30][31][32] It is therefore not surprising that bowel obstruction and or perforation is the cause of death in the majority of women with recurrent ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Impact of bowel obstruction at the time of initial presentation in women with ovarian cancer

Rauh‐Hain

Carmen

Horowitz

et al. 2009

BJOG

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Objective To determine whether the presence of bowel obstruction at the time of initial presentation has any prognostic significance in these women.Design Retrospective cohort study.Setting Dedicated gynaecological oncology service of a large tertiary institution.Population Women who had a bowel obstruction as part of their initial presentation of ovarian cancer were identified between 1995 and 2007. Each woman was matched with four control women (with disease but no obstruction).Methods Women with disease were compared with controls to determine the impact, if any, of bowel obstruction at presentation. Several prognostic variables including bowel obstruction were also evaluated in a Cox proportional hazard model. Main outcome measures Progression-free survival (PFS) and overall survival (OS).Results Forty-eight women with disease and 192 controls were identified during the study period. The median follow-up period was 19 months among women with disease versus 20 months in controls. No differences were seen in demographics and clinical characteristics of the women. Optimal cytoreduction rate was similar between the two groups (75% versus 78%, P = 0.7). Patients with bowel obstruction had a shorter PFS and OS compared with controls [19 months versus 21 months (P = 0.01) and 22 versus 35 months (P = 0.008)], respectively. Bowel obstruction at presentation was an independent prognostic variable with a hazard ratio of 1.5 (P = 0.009). Other prognostic variables were age, stage and extent of surgical cytoreduction.Conclusions Bowel obstruction at the time of initial presentation is an adverse prognostic factor in women with ovarian cancer.

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“…7 These shifts on gynecologic cancer revealed that despite an overall decrease in the mortality rate for many gynecologic cancers, both the incidence and the mortality for the elderly population are increasing, and the number of elderly women being treated for gynecologic cancers will similarly continue to increase. 8 These trends predict an influx of elderly gynecologic oncology patients with special clinical considerations.…”

Section: Introductionmentioning

confidence: 99%