(ChemotherapyAdvisor) – Among women with ovarian cancer, the elderly and those with comorbidity are less likely to receive optimal surgical and medical treatment, a study reported in Gynecologic Oncology online July 15.
However, while age 70 years and older was not found to be an independent poor prognostic factor, severe comorbidity was, noted Trine Lembrecht Jørgensen, MD, of Odense University Hospital, Odense, Denmark, and colleagues, who explored reasons behind why age might be associated with poor prognosis in patients with ovarian cancer.
They evaluated the significance of comorbidity and age ≥70 years on receipt of cytoreductive surgery, standard combination therapy (eg, paclitaxel/carboplatin), adherence to standard treatment, and prognosis in a retrospective cohort study of 961 women registered in a national database in Denmark with ovarian or peritoneal cancer in 2005-2006.
A total of 348 patients (36.2%) were age ≥70 years, which was independently predictive of not receiving surgery (OR 0.2 [95% CI 0.1–0.5]) or treatment with paclitaxel/carboplatin (OR 0.03 [95% CI 0.01–0.1]). Comorbidity also independently predicted non-receipt of standard treatment; the odds ratio for patients who received surgery with an ASA score ≥3 was 0.2 (95% CI 0.1–0.5); for receiving paclitaxel/carboplatin, it was 0.03 (95% CI 0.01–0.1).
Overall, age ≥70 years was found to be a poor prognostic factor in overall survival and progression-free survival, but the effect of age ceased after 16 months. “Comorbidity was a poor prognostic factor throughout the study period but with time-varying effect,” they noted. For patients treated with paclitaxel/carboplatin, age was not a prognostic factor, whereas ASA score ≥3 was.