title: Localized ovarian cancer in the elderly. The Gynecologic Oncology Group experience.
abstract: BACKGROUND
  The appropriate therapy for patients with localized (FIGO Stage I and II) ovarian cancer has been poorly defined for all age groups and particularly for the elderly. Few prospective randomized comparisons of adjuvant therapy after careful surgical staging have been performed. The Gynecologic Oncology Group (GOG) has performed a series of trials testing adjuvant treatment in carefully staged patients with early-stage ovarian cancer. Early trials included few elderly patients but the most recent trial (GOG 95) included 18% over the age of 65 years.
  
  
  METHODS
  Comprehensive surgical staging defined by protocol is performed before randomization. Patients with predefined stages and histologies are included and the patients are randomized prospectively to receive either intraperitoneal phosphorus-32 or three monthly cycles of cyclophosphamide and cisplatin. Assessment of the value of this adjuvant therapy will depend on survival, disease-free survival, and relapse pattern differences between the two adjuvant therapies.
  
  
  RESULTS
  This is an ongoing clinical trial and insufficient numbers of patients have been randomized for definitive conclusions. There have been seven recurrences on both arms of the trial with a median time to recurrence of 14 months. There currently are no significant age differences between relapsed patients and disease-free patients. At this point, 12 elderly patients have been randomized to each of the arms of therapy.
  
  
  CONCLUSIONS
  Although no apparent survival differences exist for elderly patients in the most recent adjuvant chemotherapy trial of early ovarian cancer, the number of patients with cancer randomized and follow-up are insufficient to establish such a difference. Currently there is no evidence that elderly patients display a significant difference in relapse frequency or pattern.
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: R C
authors.initials: RC
authors.lastname: Young
authors.forename: M F
authors.initials: MF
authors.lastname: Brady
authors.forename: L A
authors.initials: LA
authors.lastname: Walton
authors.forename: H D
authors.initials: HD
authors.lastname: Homesley
authors.forename: H E
authors.initials: HE
authors.lastname: Averette
authors.forename: H J
authors.initials: HJ
authors.lastname: Long
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D010761:Phosphorus Radioisotopes / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D010761:Phosphorus Radioisotopes; D003520:Cyclophosphamide; D002945:Cisplatin; D008558:Melphalan