Ovarian carcinoma in patients aged ≥80 years: A retrospective multicenter study of management and survival in the FRANCOGYN population

Abstract

Introduction

The aims of this study were to describe survival outcomes in patients with ovarian cancer aged ≥80 years and to explore predictors of poor prognosis.

Methods

We collected clinical, demographic, histologic, surgical and follow-up data for patients with ovarian cancer aged ≥80 years from a multicenter French cohort (FRANCOGYN) who underwent surgery from 1999 to 2019. Primary endpoints were overall survival (OS) and disease-free survival (DFS). We performed a descriptive analysis of demographic and clinical data and a survival time analysis and comparison using the Kaplan Meier method and log-rank test.

Results

Of 1671 patients treated for ovarian cancer during the study period, 83 were aged ≥80 years (median age at diagnosis, 83 years; range, 80–99). Median OS was 39.6 months (range, 23.64–60.24). Factors significantly associated with OS in the univariate analysis were adjusted Charlson comorbidity index (ACCI) (HR 2.32; 95 % CI, 1.00–5.42 for ACCI >4), FIGO stage (HR 4.07 for FIGO stage >IIA; 95 % CI, 1.43–11.54), debulking surgery (HR 0.40; 95 % CI, 0.20–0.78), residual disease after surgery (HR 3.00; 95 % CI, 1.31–6.87), and postoperative complications (HR 2.24; 95 % CI, 1.04–4.81). Significant independent predictors of worse OS in the multivariate analysis were ACCI >4 (HR 4.96; 95 % CI, 1.57–15.75), perioperative complications (HR 5.01; 95 % CI, 1.32–18.95), and residual tumor after surgical debulking (HR 3.78; 95 % CI, 1.23–11.61).

Conclusion

Age by itself should not refrain surgeons and oncologist from proposing surgical debulking and chemotherapy, as recommended by international guidelines for patients with ovarian cancer aged ≥80 years