AbstractsMedical & Health Science

Role of age in epithelial ovarian cancer

by Dunja Kozo Abramovic




Institution: Freie Universität Berlin
Department:
Degree: PhD
Year: 2014
Record ID: 1099020
Full text PDF: http://edocs.fu-berlin.de/diss/receive/FUDISS_thesis_000000097464


Abstract

Because of increasing life expectancy in the general population and limiting data, the primary aim of the present study was to analyze the impact of age on clinical outcome and survival of patients with epithelial ovarian cancer. The study cohort consisted of 446 women treated between September 2000 and April 2006 in the clinic for Gynecology, Campus Virchow-Klinikum, Charité Berlin. All clinical data were provided by the Tumor Bank Ovarian Cancer (TOC). We enrolled 269 (60.3%) patients with primary ovarian cancer (POC) and 177 (39.7%) patients with first recurrency of ovarian cancer (FROC). A systematic and validated surgical and histo-pathological tumor documentation instrument, IMO (Intraoperative Mapping of Ovarian Cancer) was used for the documentation of the tumor spread and surgical methods. Kaplan-Meier curves were calculated for overall survival (OS) and disease free survival (DFS). The Cox regression analysis was performed to identify independent predictors of mortality. In patients with POC, 77.3% were ≤65 years, 12.6% between 66 and 70 and 10% >70 years. FIGO stage III was the most common tumor stage, 55.8% ≤65, 55.9% 66-70 and 63% >70 years at primary diagnose. A complete tumor resection was achieved in 70.7% ≤65, 47.1% 66-70 and 40.7% >70 years. The OS was worse for elderly patients with residual tumor, peritoneum and level II and III tumor spread, and FIGO III and IV. In patients with FROC, 87% were ≤65 years, 8.5% between 66 and 70 and 4.5% >70 years. FIGO stage III was the most common tumor stage, 71.3% ≤65, 69.2% 66-70 and 50% >70 years at primary diagnose. A complete tumor resection was achieved in 43.5% ≤65, 60% 66-70 and 37.5% >70 years. The OS was worse for elderly patients with residual tumor and level II tumor spread. In POC is documented the mortality rate as 41.3% in patients >65 years and in FROC 64.4% >65 years. In case of Follow up, patients with POC the median was 31.3 months and patients with FROC the median was 15.9 months with range 0-100 and 0-90 months, correspondingly. The multivariable analysis showed that only stomy, residual tumor and platinum resistance patients with POC affected negatively OS, but not age. DFS were significantly worse for patients with FIGO stage III and IV and residual tumor. In patients with FROC, presence of ascites, stomy, residual tumor, and platinum resistance affected negatively OS, but not age. For DFS, patients with presence of ascites, residual tumor or platinum resistance, had significantly worse results. The results demonstrate that patients with complete tumor resection have the best OS rates in primary and in first recidive ovarian cancer. Our study demonstrates the important role of residual mass. Also presence of ascites and platinum response influence significantly OS and DFS in patients with FROC. Women older than 65 years without significant comorbidity can undergo extensive cytoreductive surgery as well as younger women younger than 65 years, suggesting that the same therapy protocols should be applied to all ovarian cancer…