title: Prognostic factors for overall survival in elderly patients with advanced ovarian cancer treated with chemotherapy: Results of a pooled analysis of three GINECO phase II trials.
abstract: BACKGROUND
  The GINECO led three multicentric prospective phase II studies, Elderly Woman Ovarian Trials 1 (EWOT1), EWOT2, and EWOT3, to evaluate the impact of geriatric covariates on the outcome of elderly patients treated with six courses of first-line chemotherapy for FIGO stage IIIIV ovarian cancer. This pooled analysis was designed to evaluate the validity of the geriatric vulnerability parameters identified in EWOT3 (Falandry et al., 2013).
  
  
  METHODS
  From 1997 to 2011, 266 patients were recruited: 83 in EWOT1, 72 in EWOT2, and 111 in EWOT3, which evaluated respectively a 4-weekly carboplatin-cyclophosphamide regimen, a 3-weekly standard carboplatin-paclitaxel doublet and a carboplatin monotherapy. All patients were analyzed in this pooled analysis for treatment completion, toxicity, and overall survival.
  
  
  RESULTS
  The global treatment completion rate was 73% and ranged from 68% in EWOT2 to 74% in EWOT3. Toxicities were generally manageable: neutropenia was more frequent in EWOT2 and thrombopenia in EWOT1 and EWOT3. In multivariate analysis, covariates associated with decreased survival were: being "depressed" according to the investigators' assessment, hypoalbuminemia <35g/L, and FIGO stage IV. In addition, a Hospital Anxiety and Depression Scale (HADS) score>14 and Instrumental Activities of Daily Living (IADL) score<25 confirmed a deleterious impact in the EWOT2+EWOT3 population subanalysis.
  
  
  CONCLUSIONS
  Despite moderate heterogeneity among the studies, this pooled analysis confirmed the deleterious effects on overall survival of emotional disorders ("depressed", as assessed by investigators or the HADS score), and decreased functionality (IADL score), in addition to FIGO stage.
authors.affiliation: Hygee Center, Regional center for Cancer Prevention, Saint Priest en Jarez, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Tinquaut
authors.affiliation: Medical Oncology unit, Centre Hospitalier Lyon Sud, Université Lyon 1, Pierre-Bénite, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Freyer
authors.affiliation: Hygee Center, Regional center for Cancer Prevention, Saint Priest en Jarez, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Chauvin
authors.affiliation: ARCAGY (Association de Recherche sur le CAncers Gynécologiques), Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Gane
authors.affiliation: Unité Cancer de la Femme et Recherche Clinique, Hôpitaux Universitaires Paris Centre, site Hôtel-Dieu, Université Paris Descartes, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Pujade-Lauraine
authors.affiliation: Geriatrics and Oncology Unit, Centre Hospitalier Lyon Sud, Université Lyon 1, Pierre-Benite, France. Electronic address: claire.falandry@chu-lyon.fr.
authors.forename: Claire
authors.initials: C
authors.lastname: Falandry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies
keywords: Elderly; Geriatrics; Ovarian cancer; Prognostic factors