title: Ovarian cancer in the elderly patient: are we doing enough?
abstract: BACKGROUND
  ovarian cancer is deadly and frequently affects older patients. In the next 20 years, the number of patients over 65 will double, and cancer, including ovarian cancer, will increase in incidence. We wished to determine whether surgical morbidity, outcomes, and survival rates were worse in the older age group than in younger patients, and whether measuring serum CA 125 could be helpful in triaging patients for surgery.
  
  
  METHODS
  we conducted a retrospective chart review of patients undergoing surgery for ovarian cancer in our institution from April 1996 to May 2006. A total of 127 patients met the inclusion criteria and were divided by age into two groups: patients aged under 70 and those aged 70 or older. We used Fisher test, two-tailed Student t test, chi-square test, and Kaplan-Meyer statistical methods to obtain survival curves and to test hypotheses and probabilities.
  
  
  RESULTS
  patients aged 70 and over were less likely to have stage I disease and to undergo optimal surgery. They also presented with more advanced disease, but this did not translate into a difference in survival rates. Serum CA 125 levels did not enable identification of older patients who would benefit from surgery.
  
  
  CONCLUSIONS
  older patients with ovarian cancer did not have reduced survival rates compared to younger patients, but they were more likely to undergo suboptimal surgery and to have more advanced disease. Preoperative serum CA 125 measurements did not identify patients in the older age group for whom surgery would be optimal.
authors.affiliation: Gynecologic Oncology Division, Centre Hospitalier Universitaire de Québec-L'Hôtel-Dieu de Québec, Quebec, QC.
authors.forename: Marie Claude
authors.initials: MC
authors.lastname: Renaud
authors.affiliation: Gynecologic Oncology Division, Centre Hospitalier Universitaire de Québec-L'Hôtel-Dieu de Québec, Quebec, QC.
authors.forename: Marie
authors.initials: M
authors.lastname: Plante
authors.affiliation: Gynecologic Oncology Division, Centre Hospitalier Universitaire de Québec-L'Hôtel-Dieu de Québec, Quebec, QC.
authors.forename: Jean
authors.initials: J
authors.lastname: Grégoire
authors.affiliation: Gynecologic Oncology Division, Centre Hospitalier Universitaire de Québec-L'Hôtel-Dieu de Québec, Quebec, QC.
authors.forename: Michel
authors.initials: M
authors.lastname: Roy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D018394:CA-125 Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D018394:CA-125 Antigen