The influence of age and co-morbidity on treatment and prognosis of ovarian cancer: a population-based study

• Published in: Gynecologic oncology Vol. 97; no. 1; pp. 104 - 109
• Main Authors: Maas, H.A.A.M., Kruitwagen, R.F.P.M., Lemmens, V.E.P.P., Goey, S.H., Janssen-Heijnen, M.L.G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2005
• Subjects: Age Factors; Aged; Cancer registry; Co-morbidity; Comorbidity; Elderly; Female; Humans; Neoplasm Staging; Netherlands - epidemiology; Ovarian cancer; Ovarian Neoplasms - epidemiology; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Prevalence; Prognosis; Survival Rate; Treatment; Netherlands; Treatment; Prognosis; Cancer registry; Elderly; Co-morbidity; Ovarian cancer
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2004.12.026

With the rising mean age, more patients will have one or more other serious diseases at the time of diagnosis of ovarian cancer (co-morbidity). In this study, the independent effects of age and co-morbidity on the application of treatment guidelines and prognosis were evaluated. All patients with epithelial ovarian cancer diagnosed between 1995 and 2001 in the southern part of The Netherlands ( N = 1116) were included. The prevalence of co-morbidity increased from 34% of the age group <70 to 63% of the older age group. Eighty-three percent of the patients with FIGO stage II or stage III younger than 70 years underwent the advised treatment (combination of surgery and chemotherapy) compared to only 45% of the patients aged 70 or older. In a multivariable analysis age, FIGO stage, presence of co-morbidity, and year of diagnosis seemed to be independent predictors of receiving the advised treatment. In multivariable analyses age 70 + (HR = 1.3, 95% CI = 1.03–1.7) and the use of both surgery and chemotherapy (HR = 0.4, 95% CI = 0.3–0.6, reference is only surgery) were independent prognostic factors for overall survival. Even in the absence of co-morbidity, standard combination therapy was prescribed significantly less often for elderly patients with FIGO II or III ovarian cancer. Age and combined treatment of surgery and platinum-based chemotherapy were independent prognostic factors. Co-morbidity did not seem to have a prognostic effect.