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Epithelial ovarian cancer in the elderly: The memorial sloan‐kettering cancer center experience
Author(s) -
Markman Maurie,
Lewis John L.,
Saigo Patricia,
Hakes Thomas,
Jones Walter,
Rubin Stephen,
Reichman Bonnie,
Barakat Richard,
Curtin John,
Almadrones Lois,
Morrissey Tom,
Hoskins William
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.2820710222
Subject(s) - medicine , cancer , center (category theory) , gynecology , epithelial ovarian cancer , oncology , ovarian cancer , gerontology , chemistry , crystallography
Background . There is evidence of differences between older (≥ 65 years of age) and younger (< 65 years of age) women with ovarian cancer. Methods . To evaluate differences in the care of older versus younger patients with ovarian cancer, a retrospective review was conducted of the records of 146 patients who had their initial surgery for ovarian cancer at the Memorial Sloan‐Kettering Cancer Center from January 1987–January 1991. Results . There was a significant difference in stage at presentation between the older (48 patients) and younger (98 patients) populations (Stage I/II: older 10%; younger 25%; P < 0.05). Although there was no statistically significant difference in the distributions of patients according to tumor grade between the two groups, 10% of the younger patients had ovarian cancer of low malignant potential, compared to only 2% of older patients ( P < 0.1). Forty‐six percent of the younger patients entered an intensive initial chemotherapy trial compared to only 17% of the older patients ( P < 0.001), principally due to comorbid medical conditions (e.g., heart disease). Finally, whereas the relative number of younger to older patients with ovarian cancer undergoing initial surgery at this institution was 2:1, the relative number of totally new patients to the service (including referral for initial treatment or salvage programs) was 4:1 ( P < 0.001), suggesting that older patients with ovarian cancer are less likely to be referred for secondary experimental programs than for initial treatment. Conclusions . These data suggest that there are major differences between the presentation and treatment strategies of older compared to younger patients with ovarian cancer.