EP249/#909 Management of elderly patients with ovarian cancer: from surgery to medical therapy

Objectives

Incidence of ovarian cancer increases with advancing age and reaches a peak at 70 years. The aim of this study is to analyse the surgical and pharmacological approach to elderly patients affected by ovarian cancer evaluating different outcomes and complications in different groups of patients.

Methods

We have conducted a multicenter retrospective study including patients treated in Sant’Anna Hospital and Mauriziano Hospital in Turin. Patients diagnosed with ovarian cancer were included and divided according to age at diagnosis in group A (≥70 years) and group B (<70 years). For each patient are considered: co-morbidities, performance status, FIGO stage, grading, histotype, surgical treatment (divided in standard, radical and ultra-radical) and chemotherapy details.

Results

457 patients were included in the study, 138 (30.2%) in group A and 319 (69.8%) in group B. Optimal cytoreduction was achieved in 84.3% of the younger patients and in 73.2 % of the older patients (p=0.005), although the surgical extension is not statistically significant different in the two groups (p=0.64). Disease free survival (DFS) was not statistically different in the two groups even in early and advanced stages (figure 1 and 2). The residual tumour (OR=2.286; p=0.0005) and the ultraradical surgery (OR=1.434; p=0.015) resulted as independent survival prognostic factors according to the multivariate Cox analysis.

Conclusions

Our data suggest that elderly patients can tolerate radical surgical treatments without a significant increase in morbidity, so an optimal cytoreduction should be considered the gold standard without ignoring the importance of managing these patients within Gynecologic Oncology units equipped with a multidisciplinary team.