Ovarian Cancer In The Elderly: Further Considerations

Main Category: Ovarian Cancer
Also Included In: Cancer / Oncology;  Seniors / Aging
Article Date: 07 Jan 2009 - 3:00 PDT

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Piver gives his perspective on the management of epithelial ovarian cancer in the elderly. This subject has been dealt with previously by numerous authors, with a general consensus that advancing age is an independent negative prognostic factor when multivariate statistics are applied to the multiple parameters affecting outcome.

How much of the poor outcome is due to intrinsic biologic factors vs less aggressive surgical and medical therapy remains unclear. Piver's manuscript deals primarily with the operative and medical management of ovarian cancer in the elderly. However, ample data suggest that age-related biologic differences exist.

In a retrospective analysis of more than 2,000 patients from four Gynecologic Oncology Group (GOG) studies performed prior to the taxane era, Thigpen showed that advanced age was an independent and negative prognostic factor that could not be overcome by more aggressive debulking surgery.

A similar retrospective study of primary therapy in the taxane era was reported by Winter and again showed advanced age to have a negative effect on outcome irrespective of residual tumor volume. Conversely, a recent retrospective analysis from a single institution showed similar rates of clinical complete response, platinum sensitivity at 6 months, progression-free survival and overall survival for patients < 65 and > 65 years old.

This article reviews the following: 21st Century Challenge of Ovarian Cancer in the Elderly: A Personal Perspective .

WILLIAM P. MCGUIRE, MD

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