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open access
Our results are in line with several previous studies [4], [5], [11], [13], [14], [22], and in particular, our findings are concordant with two recent studies [11], [13] showing that age is an independent predictor of non-administration of either surgery or chemotherapy.
Background
Ovarian cancer is the fourth most common cancer among women in France, and mainly
affects the elderly. The primary objective of this study was to compare treatment
of ovarian cancer according to age.
Methods
All patients with invasive cancer (n = 1151) diagnosed between 1997 and 2011 in the Herault Department of southern France
were included. Demographic data (age, area of residence), cancer characteristics (stage,
histology, grade) and treatment modality (type, period and location of treatment)
were analysed. Univariate and multivariate logistic regression was used to compare
treatment by age.
Results
Ovarian cancer was less treated in elderly compared to younger patients, regardless
of the type of treatment. This difference was more pronounced for chemotherapy, and
was maximal for surgery followed by chemotherapy (odds ratio (OR) for surgery for
patients aged >70 vs those aged <70 years = 0.47 [0.24–0.91], OR for chemotherapy,
age >70 vs <70 = 0.30 [0.16–0.55] and OR for surgery plus chemotherapy, age >70 vs
<70 = 0.14 [0.08–0.28]). This effect of age was independent of other variables, including
stage and grade. The probability of receiving standard treatment, in accordance with
recommendations, was reduced by 50 % in elderly patients compared to their younger
counterparts. Overall and net survival of elderly patients with standard treatment
was similar to those of younger patients treated outside standard treatment.
Conclusions
Elderly women with ovarian cancer were therapeutically disadvantaged compared to younger
women. Further studies including co morbidities are necessary to refine these results
and to improve therapeutic management of elderly patients with ovarian cancer.
Background
Cancer is the second leading cause of death in women after cardiovascular disease.
In France, the number of new cancer cases increased significantly between 1980 and
2012 [1]. This increase is largely due to the increase in population and aging, which automatically
increases the number of cases, particularly those occurring in the elderly. In Western
countries, ovarian cancer remains the leading gynecological cause of death [2]. Ovarian cancer represents the 6
th
cause of cancer and the 4
th
cause of death in women in France. Nearly 4600 new cases are diagnosed, and nearly
3100 women die of this disease annually in France [1].......
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