Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group
Background and objective: Elderly and/or frail women with ovarian cancer are often undertreated. The aim of the study is to compare the effects of age and frailty on surgical approaches, postoperative complications, and prognosis in elderly women with ovarian cancer. Methods: A retrospective multice...
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| Format: | Article |
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1339 |
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| author | Ludivine Dion Camille Mimoun Krystel Nyangoh Timoh Sofiane Bendifallah Alexandre Bricou Pierre Collinet Cyril Touboul Lobna Ouldamer Henri Azaïs Yohann Dabi Cherif Akladios Geoffroy Canlorbe Pierre-Adrien Bolze Hélène Costaz Mathieu Mezzadri Tristan Gauthier Frederik Kridelka Pauline Chauvet Nicolas Bourdel Martin Koskas Xavier Carcopino Emilie Raimond Olivier Graesslin Lise Lecointre Marcos Ballester Jean Levêque Cyrille Huchon Vincent Lavoué |
| author_facet | Ludivine Dion Camille Mimoun Krystel Nyangoh Timoh Sofiane Bendifallah Alexandre Bricou Pierre Collinet Cyril Touboul Lobna Ouldamer Henri Azaïs Yohann Dabi Cherif Akladios Geoffroy Canlorbe Pierre-Adrien Bolze Hélène Costaz Mathieu Mezzadri Tristan Gauthier Frederik Kridelka Pauline Chauvet Nicolas Bourdel Martin Koskas Xavier Carcopino Emilie Raimond Olivier Graesslin Lise Lecointre Marcos Ballester Jean Levêque Cyrille Huchon Vincent Lavoué |
| author_sort | Ludivine Dion |
| collection | DOAJ |
| description | Background and objective: Elderly and/or frail women with ovarian cancer are often undertreated. The aim of the study is to compare the effects of age and frailty on surgical approaches, postoperative complications, and prognosis in elderly women with ovarian cancer. Methods: A retrospective multicenter study of women ≥70 years were treated for ovarian cancer at seven French university hospitals between 2007 and 2015. Results: Of the 1119 women treated for ovarian cancer during the study period, 147 were ≥70 years and had complete data. Of these women, 65 were aged 70–74 years, and 82 were aged ≥75 years. Overall, 77% of the younger women (49/65) received optimal treatment compared with 51% (40/82) of the older women (<i>p</i> = 0.018). Women ≥75 years underwent fewer bowel resections (32% vs. 67%, <i>p</i> < 0.001) and experienced fewer postoperative complications (22.6% vs. 38.9%, <i>p</i> < 0.001); 53.2% of the women in this age group were treated by primary surgery or surgery only. These women also received more chemotherapy with platinum only (15% [9/56] vs. 2% [1/57], <i>p</i> = 0.007) and less bevacizumab (9% [5/56] vs. 32% [18/57], <i>p</i> = 0.003). Patients with greater frailty (a modified Charlson Comorbidity Index [mCCI] score >3) had a five-year survival rate of 30% versus 62% for those with a score ≤3 (<i>p</i> < 0.001). Conclusions: Surgeons modify their approach to treating ovarian cancer in women ≥75 years probably to reduce immediate postoperative complications. The prognosis is significantly worse in patients with greater frailty. Improvements to the sequence of treatments administered, with priority given to neoadjuvant chemotherapy in patients with greater frailty, could help increase the number of women who receive optimal treatment and improve their prognosis. |
| first_indexed | 2024-03-10T20:02:07Z |
| format | Article |
| id | doaj.art-19247e888500493dbda02daad75f6e21 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T20:02:07Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-19247e888500493dbda02daad75f6e212023-11-19T23:27:36ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195133910.3390/jcm9051339Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN GroupLudivine Dion0Camille Mimoun1Krystel Nyangoh Timoh2Sofiane Bendifallah3Alexandre Bricou4Pierre Collinet5Cyril Touboul6Lobna Ouldamer7Henri Azaïs8Yohann Dabi9Cherif Akladios10Geoffroy Canlorbe11Pierre-Adrien Bolze12Hélène Costaz13Mathieu Mezzadri14Tristan Gauthier15Frederik Kridelka16Pauline Chauvet17Nicolas Bourdel18Martin Koskas19Xavier Carcopino20Emilie Raimond21Olivier Graesslin22Lise Lecointre23Marcos Ballester24Jean Levêque25Cyrille Huchon26Vincent Lavoué27Department of Gynecology, Rennes University Hospital, 35000 Rennes, FranceDepartment of Gynecology and Obstetrics, Lariboisiere Hospital, 750019 Paris, FranceDepartment of Gynecology, Rennes University Hospital, 35000 Rennes, FranceService de Gynécologie, Hopital TENON, AP-HP, 75020 Paris, FranceService de Chirurgie Gynécologique, Hôpital Croix Saint Simon, 75000 Paris, FranceService de Gynécologie, Hôpital Jeanne de Flandres, 59000 Lille, FranceService de Gynécologie, Hopital TENON, AP-HP, 75020 Paris, FranceService de Gynécologie, 37000 Tours, FranceService de Gynécologie, Hôpital La Pitié Salpétrière, 75012 Paris, FranceService de Gynécologie Obstétrique, Centre Hospitalier Inter Communal de Créteil, 94000 Créteil, FranceService de Gynécologie Obstétrique, CHU Hautepierre, 67000 Strasbourg, FranceService de Gynécologie, Hôpital La Pitié Salpétrière, 75012 Paris, FranceService de Gynécologie Obstétrique, CHU Lyon Sud, 69000 Lyon, FranceDépartement d’Oncologie Chirurgicale, Centre Georges François Leclerc, 21000 Dijon, FranceDepartment of Gynecology and Obstetrics, Lariboisiere Hospital, 750019 Paris, FranceService de Gynécologie Obstétrique, CHU de Limoges, 87000 Limoges, FranceService de Chirurgie Oncologique et Gynécologique, 4000 Liège, BelgiqueService de Gynécologie Obstétrique, CHU de Clermont Ferrand, 63000 Clermont Ferrand, FranceService de Gynécologie Obstétrique, CHU de Clermont Ferrand, 63000 Clermont Ferrand, FranceService de Gynécologie, Hôpital Bichat, APHP, 75018 Paris, FranceService de Gynécologie, Hôpital La Timone, APHM, 13000 Marseille, FranceService de Gynécologie, Hôpital Universitaire de Reims, 51000 Reims, FranceService de Gynécologie, Hôpital Universitaire de Reims, 51000 Reims, FranceService de Gynécologie Obstétrique, CHU Hautepierre, 67000 Strasbourg, FranceService de Chirurgie Gynécologique, Hôpital Croix Saint Simon, 75000 Paris, FranceDepartment of Gynecology, Rennes University Hospital, 35000 Rennes, FranceDepartment of Gynecology and Obstetrics, Lariboisiere Hospital, 750019 Paris, FranceDepartment of Gynecology, Rennes University Hospital, 35000 Rennes, FranceBackground and objective: Elderly and/or frail women with ovarian cancer are often undertreated. The aim of the study is to compare the effects of age and frailty on surgical approaches, postoperative complications, and prognosis in elderly women with ovarian cancer. Methods: A retrospective multicenter study of women ≥70 years were treated for ovarian cancer at seven French university hospitals between 2007 and 2015. Results: Of the 1119 women treated for ovarian cancer during the study period, 147 were ≥70 years and had complete data. Of these women, 65 were aged 70–74 years, and 82 were aged ≥75 years. Overall, 77% of the younger women (49/65) received optimal treatment compared with 51% (40/82) of the older women (<i>p</i> = 0.018). Women ≥75 years underwent fewer bowel resections (32% vs. 67%, <i>p</i> < 0.001) and experienced fewer postoperative complications (22.6% vs. 38.9%, <i>p</i> < 0.001); 53.2% of the women in this age group were treated by primary surgery or surgery only. These women also received more chemotherapy with platinum only (15% [9/56] vs. 2% [1/57], <i>p</i> = 0.007) and less bevacizumab (9% [5/56] vs. 32% [18/57], <i>p</i> = 0.003). Patients with greater frailty (a modified Charlson Comorbidity Index [mCCI] score >3) had a five-year survival rate of 30% versus 62% for those with a score ≤3 (<i>p</i> < 0.001). Conclusions: Surgeons modify their approach to treating ovarian cancer in women ≥75 years probably to reduce immediate postoperative complications. The prognosis is significantly worse in patients with greater frailty. Improvements to the sequence of treatments administered, with priority given to neoadjuvant chemotherapy in patients with greater frailty, could help increase the number of women who receive optimal treatment and improve their prognosis.https://www.mdpi.com/2077-0383/9/5/1339ovarian cancerelderlysurgerychemotherapyfrailty |
| spellingShingle | Ludivine Dion Camille Mimoun Krystel Nyangoh Timoh Sofiane Bendifallah Alexandre Bricou Pierre Collinet Cyril Touboul Lobna Ouldamer Henri Azaïs Yohann Dabi Cherif Akladios Geoffroy Canlorbe Pierre-Adrien Bolze Hélène Costaz Mathieu Mezzadri Tristan Gauthier Frederik Kridelka Pauline Chauvet Nicolas Bourdel Martin Koskas Xavier Carcopino Emilie Raimond Olivier Graesslin Lise Lecointre Marcos Ballester Jean Levêque Cyrille Huchon Vincent Lavoué Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group Journal of Clinical Medicine ovarian cancer elderly surgery chemotherapy frailty |
| title | Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group |
| title_full | Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group |
| title_fullStr | Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group |
| title_full_unstemmed | Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group |
| title_short | Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group |
| title_sort | ovarian cancer in the elderly time to move towards a more logical approach to improve prognosis a study from the francogyn group |
| topic | ovarian cancer elderly surgery chemotherapy frailty |
| url | https://www.mdpi.com/2077-0383/9/5/1339 |
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