title: Age contrasts in patients with advanced epithelial ovarian cancer. The M.D. Anderson Cancer Center experience.
abstract: BACKGROUND
  This study reviews the experience at the University of Texas M.D. Anderson Cancer Center with elderly patients treated for advanced epithelial ovarian cancer with cisplatin-based combination chemotherapy.
  
  
  METHODS
  From 1978 through 1988, 215 patients with Stage III or IV, Grade 2 or 3 epithelial ovarian cancer were entered onto one of three consecutive trials involving cisplatin-based combination chemotherapy. The treatment plans were as follows: Trial 1: 12 cycles of cisplatin-melphalan (75 patients); Trial 2: 12 cycles of cisplatin-cyclophosphamide (49 patients); and Trial 3: 6 cycles of cisplatin-cyclophosphamide (91 patients). End-points of analysis included the effect of age on other prognostic factors, clinical response rate, surgical response rate, toxicity, progression-free survival, and survival.
  
  
  RESULTS
  Of the entire study group, 57 patients (27%) were 65 years of age and older at diagnosis. There was no effect of age on FIGO stage or histologic grade distribution, but 61% of patients younger than 65 years of age had residual tumors less than or equal to 2 cm compared with only 33% of patients 65 years of age and older (P = 0.00027). There were no differences between the two age groups with respect to response rates, recurrence rate after negative second-look surgery, toxicity, or progression-free survival. Patients in the younger than 65 years of age group, however, had a significantly longer median survival time than those 65 years of age and older (30 versus 19 months, respectively) (P = 0.0038).
  
  
  CONCLUSIONS
  This analysis suggests that elderly patients are more likely to begin chemotherapy with bulky residual disease and to have a significantly shorter survival time than their younger counterparts.
authors.affiliation: Department of Gynecology, University of Texas M.D. Anderson Cancer Center, Houston, 77030.
authors.forename: D M
authors.initials: DM
authors.lastname: Gershenson
authors.forename: M F
authors.initials: MF
authors.lastname: Mitchell
authors.forename: N
authors.initials: N
authors.lastname: Atkinson
authors.forename: E G
authors.initials: EG
authors.lastname: Silva
authors.forename: T W
authors.initials: TW
authors.lastname: Burke
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.forename: J J
authors.initials: JJ
authors.lastname: Kavanagh
authors.forename: D
authors.initials: D
authors.lastname: Warner
authors.forename: J T
authors.initials: JT
authors.lastname: Wharton
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D002945:Cisplatin