991P - Patterns and outcomes of treatment in elderly patients with ovarian cancer: a retrospective mono-istitutional study

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Ovarian Cancer
Geriatric Oncology
Presenter Maria O. Nicoletto
Authors M.O. Nicoletto1, L. Furini1, M. Dalla Palma1, L. Borgato2, P. Fiduccia1, M. Rocchetto3, G.B. Nardelli4, M.T. Gervasi5, V. Zagonel6
  • 1Medical Oncology Unit 1, Istituto Oncologico Veneto, 35128 - Padua/IT
  • 2Oncologia Medica 1, Istituto Oncologico Veneto, 35128 - Padua/IT
  • 3School Of Medicine, University of Padua, School of Medicine, 35128 - Padua/IT
  • 4Deapartment Of Gynecological Sciences And Human Reproduction, University of Padua, 35128 - Padua/IT
  • 5Ob/gyn Unit Department For Health Of Mothers And Children, Azienda Ospedaliera, 35128 - Padua/IT
  • 6Department Of Oncology, Istituto Oncologico Veneto, 35128 - Padua/IT

Abstract

Introduction

Ovarian cancer incidence is increasing in the elderly. We studied clinical and biological features of ovarian cancer in patients (OCP) aged >or = 70y.

Methods

We conducted a retrospective analysis in 100 elderly OCP observed from 1995 to 2011. We considered overall survival, comorbidities, surgery, hystotype and grading, chemotherapy (monochemotherapy vs polychemotherapy), response to treatment, and toxicities.

Results

Median age was 75y (range 70-88y). Most of the pts (82%) had advanced stage at diagnosis (stage III, 70.2%), serous ovarian cancer histotype (67%), and grade 3 (74 pts, 78.7%). Most pts had at least one comorbidity (84%) and more than half (53.2%) two or more. 29.8% of pts received an optimal debulking (<1 cm of residual disease), 35.1% sub-optimal surgery, 23.4% underwent surgery after a median of 6 cycles of neoadjuvant chemotherapy, and 11.7% did not receive any surgery. 64 pts were treated with carboplatin AUC4-paclitaxel 135 mg/m2 in 3h d1 q21 and 12 pts received only carboplatin. The median number of cycles administered was 6 (range 1-11). 59 pts (62.8%) obtained a complete remission, 18 pts (19.1%) a partial remission, 9 pts a stable disease (9.6%), and 8 pts (8.5%) a progression. The median duration of response was 19 months (range 0-197). Chemotherapy was well tolerated; 22 adverse events were observed (in 570 total cycles administered), with neutropenia the most frequent one, particularly in patients undergoing polychemotherapy. 53 pts relapsed and 42 received a 2nd line chemotherapy. The median survival was 45 months. By univariate analysis, patient survival was related to surgery (optimal primary surgery vs suboptimal) and to response to chemotherapy. By multivariate analysis, optimally debulked pts, treated with adjuvant chemotherapy, had a risk of death of 35% lower than patients who were suboptimally treated. The median survival was 38 months in the optimally treated group.

Conclusion

The importance of integrated optimal treatment also in elderly OCP is confirmed. A prognosis in advanced age OCP is related to the biological characteristics of the disease and to the optimal integrated surgical and polychemotherapy treatment. The presence of comorbidities does not have a negative impact on survival of OCP and does not influence significantly the tolerance to chemotherapy.

Disclosure

All authors have declared no conflicts of interest.