Poorer survival of elderly patients with ovarian cancer: a population-based study.
OBJECTIVE
To compare ovarian cancer survival in elderly and young patients.


METHODS
Using the Geneva Cancer Registry, we identify women diagnosed with primary ovarian cancer between 1980 and 1998. We compared tumors characteristics, treatment patterns of young patients (<or=70 years) versus older patients (>70 years) by logistic regression. To evaluate the effect of age on prognosis, we compared disease specific survival by Cox proportional hazard analysis, taking into account other prognostic factors.


RESULTS
This study included 285 patient aged 70 years and 451<or=70 years. Older women presented more advanced stage and at equal stage were less often treated by optimal surgery and chemotherapy. Five-year of disease specific survival was 18% (95% CI: 13-23%) and 53% (95% CI: 48-58%) among old versus young women. Over ovarian mortality was only partly explained by these differences and after adjustment for tumor characteristics and treatment, older women still had a 1.8-fold increased risk of dying of ovarian cancer compared to younger (HR 1.8, 95% CI: 1.4-2.4).


CONCLUSIONS
Age strongly decreases ovarian cancer mortality. This over mortality is only partly explained by later diagnosis and suboptimal treatment.
Petignat
P
P
Department of Obstetrics and Gynecology, Gynecologic Oncology and Senology, Geneva University Hospitals, 30 Boulevard de la Cluse, 1211 Geneva 14, Switzerland.
Fioretta
G
G
Verkooijen
H M
HM
Vlastos
A T
AT
Rapiti
E
E
Bouchardy
C
C
Vlastos
G
G
D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D012042:Registries; D016019:Survival Analysis; D013557:Switzerland / Q000453:epidemiology