TY - JOUR
T1 - Impact of surgery and chemotherapy timing on outcomes in older versus younger epithelial ovarian cancer patients
T2 - A nationwide Danish cohort study
AU - Ekmann-Gade, Anne Weng
AU - Schnack, Tine Henrichsen
AU - Seibæk, Lene
AU - Noer, Mette Calundann
AU - Høgdall, Claus
N1 - Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2023
Y1 - 2023
N2 - INTRODUCTION: To explore differences in surgical complexity, chemotherapy administration, and treatment delays between younger and older Danish patients with epithelial ovarian cancer (EOC).MATERIALS AND METHODS: We included a nationwide cohort diagnosed with EOC from 2013 to 2018. We described surgical complexity and outcomes, the extent of chemotherapy and treatment delays stratified by age (<70 and ≥ 70 years), and surgical modality (primary, interval, or no debulking surgery).RESULTS: In total, we included 2946 patients. For patients with advanced-stage disease, 52% of the older patients versus 25% of the younger patients did not undergo primary debulking surgery (PDS) or interval debulking surgery (IDS). For patients undergoing PDS or IDS, older patients underwent less extensive surgery and more often had residual disease after surgery >0 cm compared to younger patients. Furthermore, older patients were less often treated with chemotherapy. Older patients had PDS later than younger. We did not find any differences between age groups concerning treatment delays. Two-year cancer-specific survival differed significantly between age groups regardless of curatively intended treatment.DISCUSSION: This study demonstrates that older patients are treated less actively concerning surgical and oncological treatment than younger patients, leading to worse cancer-specific survival. Older patients do not experience more treatment delays than younger ones.
AB - INTRODUCTION: To explore differences in surgical complexity, chemotherapy administration, and treatment delays between younger and older Danish patients with epithelial ovarian cancer (EOC).MATERIALS AND METHODS: We included a nationwide cohort diagnosed with EOC from 2013 to 2018. We described surgical complexity and outcomes, the extent of chemotherapy and treatment delays stratified by age (<70 and ≥ 70 years), and surgical modality (primary, interval, or no debulking surgery).RESULTS: In total, we included 2946 patients. For patients with advanced-stage disease, 52% of the older patients versus 25% of the younger patients did not undergo primary debulking surgery (PDS) or interval debulking surgery (IDS). For patients undergoing PDS or IDS, older patients underwent less extensive surgery and more often had residual disease after surgery >0 cm compared to younger patients. Furthermore, older patients were less often treated with chemotherapy. Older patients had PDS later than younger. We did not find any differences between age groups concerning treatment delays. Two-year cancer-specific survival differed significantly between age groups regardless of curatively intended treatment.DISCUSSION: This study demonstrates that older patients are treated less actively concerning surgical and oncological treatment than younger patients, leading to worse cancer-specific survival. Older patients do not experience more treatment delays than younger ones.
KW - Chemotherapy
KW - Debulking surgery
KW - Epithelial ovarian cancer
KW - Survival
KW - Time to treatment
UR - http://www.scopus.com/inward/record.url?scp=85136158324&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2022.08.008
DO - 10.1016/j.jgo.2022.08.008
M3 - Journal article
C2 - 35989185
SN - 1879-4068
VL - 14
SP - 1
EP - 8
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 1
M1 - 101359
ER -