Significance of age and comorbidity on treatment modality, treatment adherence, and prognosis in elderly ovarian cancer patients

Jørgensen, Trine Lembrecht; Teiblum, S.; Paludan, Merete; Poulsen, Laurids Østergaard; Jørgensen, A. Y. S.; Bruun, Karin Herskind; Hallas, Jesper; Herrstedt, Jørn

doi:10.1016/j.ygyno.2012.07.001

Cited by 73 publications

(78 citation statements)

References 32 publications

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“…In a cohort of 961 Danish women with ovarian cancer, 63% of patients aged less than 70 years were diagnosed in stage III-IV compared with 73% of those aged 70 years or more. Furthermore, whereas 97% in the younger group underwent primary debulking surgery or interval debulking surgery after neoadjuvant chemotherapy, this was only the case for 85% of patients aged 70 years or more and the proportion of optimally debulked patients (residual tumor 51 cm) was 66% versus 51% respectively [17]. Also the number of patients receiving combination chemotherapy (carboplatin plus paclitaxel) was lower in the group of older cancer patients (77% versus 43%).…”

Section: Discussionmentioning

confidence: 93%

Trends in gynecologic cancer among elderly women in Denmark, 1980–2012

et al. 2016

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Background The aim of this analysis was to describe trends in incidence, mortality, prevalence, and survival in Danish women with gynecologic cancer from 1980-2012 comparing women aged 70 years or more with younger women. Material and methods Gynecologic cancers included were ICD-10 codes C53 (cancer of the cervix uteri), C54 (corpus uteri cancer), C56 (ovarian cancer) and C57 (Fallopian tube cancer). Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence and relative survival in the Nordic countries, where the Danish data are delivered from the Danish Cancer Registry and the Danish Cause of Death Registry with follow-up for death or emigration until the end of 2013. Results For cervical cancer the incidence decreased among women aged less than 70 years and remained stable among the elderly. The mortality rates were clearly separated by age groups with a 2-3 fold higher mortality rate among 70 + years-old than younger women. The mortality rates, however, decreased in all age groups from 1980-2012. For ovarian and Fallopian tube cancers the incidence was almost constant, whereas the average annual number of deaths decreased over time from 466 in 1980 to 396 in 2012. The mortality rates were clearly separated by age groups with mortality rates 3-4 times higher among the elderly. The mortality rate decreased among women less than 70 years during the entire period. The average annual number of newly diagnosed corpus uteri cancer increased from 631 in 1980 to 773 in 2012. The mortality rates were clearly separated by age groups with much higher mortality rates among the 70+ years-old as compared with younger women. Overall the mortality rates decreased from 1980 to 2012. Conclusion In gynecologic cancer both mortality rates and survival are age-dependent with a significantly shorter survival in the group of elderly.

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Section: Discussionmentioning

confidence: 93%

Trends in gynecologic cancer among elderly women in Denmark, 1980–2012

et al. 2016

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“…Elderly patients have been less likely to undergo standard treatments for ovarian cancer, such as optimal debulking surgery, and have been less likely to complete chemotherapy. Indeed, it has been reported that, among patients who do receive optimal treatment, old age is not an independent poor prognostic factor [42]. …”

Section: Discussionmentioning

confidence: 99%

Trends in gynecologic cancer mortality in East Asian regions

et al. 2014

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ObjectiveTo evaluate uterine and ovarian cancer mortality trends in East Asian countries.MethodsFor three Asian countries and one region (Japan, Korea, Singapore, and Hong Kong), we extracted number of deaths for each year from the World Health Organization (WHO) mortality database, focusing on women ≥20 years old. The WHO population data were used to estimate person-years at risk for women. The annual age-standardized, truncated rates were evaluated for four age groups. We also compared age-specific mortality rates during three calendar periods (1979 to 1988, 1989 to 1998, and 1999 to 2010). Joinpoint regression was used to determine secular trends in mortality. To obtain cervical and uterine corpus cancer mortality rates in Korea, we re-allocated the cases with uterine cancer of unspecified subsite according to the proportion in the National Cancer Incidence Databases.ResultsOverall, uterine cancer mortality has decreased in each of the Asian regions. In Korea, corrected cervical cancer mortality has declined since 1993, at an annual percentage change (APC) of -4.8% (95% confidence interval [CI], -5.3 to -4.4). On the other hand, corrected uterine corpus cancer mortality has abruptly increased since 1995 (APC, 6.7; 95% CI, 5.4 to 8.0). Ovarian cancer mortality was stable, except in Korea, where mortality rates steadily increased at an APC of 6.2% (95% CI, 3.4 to 9.0) during 1995 to 2000, and subsequently stabilized.ConclusionAlthough uterine cancer mortality rates are declining in East Asia, additional effort is warranted to reduce the burden of gynecologic cancer in the future, through the implementation of early detection programs and the use of optimal therapeutic strategies.

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“…Age has been shown to influence treatment decisions and outcome in ovarian cancer. 13Y17 However, when older patients receive standard combination chemotherapy, their outcomes are comparable with younger patients, 12 and in our study, age was not an independent prognostic factor. After adjusting for covariates known to affect chemotherapy selection, there was still greater than 5 times higher mortality rate among patients receiving single-agent carboplatin compared with patients receiving combination chemotherapy.…”

Section: Discussionmentioning

confidence: 44%