title: Elderly and very elderly advanced ovarian cancer patients: does the age influence the surgical management?
abstract: BACKGROUND
  To examine the surgical treatment and clinical outcome of elderly and very elderly advanced epithelial ovarian cancer patients.
  
  
  METHODS
  We retrospectively analyzed FIGO stage IIIC-IV ovarian cancer patients, divided in elderly (Group A, >65 and <75 years) and very elderly patients (Group B, ≥ 75 years) treated by primary debulking surgery (PDS) or by interval debulking surgery (IDS) at the Catholic University at Rome and Campobasso, Italy.
  
  
  RESULTS
  164 patients were included: 123 (Group A) and 41 (Group B). Complete cytoreduction was achieved in 60 patients (60.6%) in Group A and in 20 patients (62.5%) in Group B (p = 0.75). In the remaining cases, optimal cytoreduction was performed (39 cases (39.4%) in Group A and 12 (37.5%) in Group B; p = 0.75). In Group A complete/optimal debulking was achieved in 53 patients (53.5%) at PDS and in 46 patients (46.5%) at IDS (p = 0.55). In the Group B a higher rate of patients was debulked at IDS with respect to PDS (10 (31.3%) vs. 22 patients (68.7%); p = 0.02). In Group A patients debulked at PDS showed better DFS (p = 0.007) and OS (p = 0.003) with respect to patients submitted to successful IDS, whereas in group B we did not observed any survival difference according to time of cytoreduction.
  
  
  CONCLUSIONS
  Our data suggest that elderly and very elderly patients may tolerate radical and ultra-radical surgery. These patients should be managed in a gynecologic oncology unit, with prudent but complete approach.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy. francesco.fanfani@rm.unicatt.it
authors.forename: F
authors.initials: F
authors.lastname: Fanfani
authors.forename: A
authors.initials: A
authors.lastname: Fagotti
authors.forename: M G
authors.initials: MG
authors.lastname: Salerno
authors.forename: P A
authors.initials: PA
authors.lastname: Margariti
authors.forename: M L
authors.initials: ML
authors.lastname: Gagliardi
authors.forename: V
authors.initials: V
authors.lastname: Gallotta
authors.forename: G
authors.initials: G
authors.lastname: Vizzielli
authors.forename: G
authors.initials: G
authors.lastname: Panico
authors.forename: G
authors.initials: G
authors.lastname: Monterossi
authors.forename: G
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D009367:Neoplasm Staging / Q000379:methods*; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D010052:Ovariectomy / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome