Poorer survival of elderly patients with ovarian cancer: a population-based study

OBJECTIVE: To compare ovarian cancer survival in elderly and young patients.

MATERIAL AND 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).

CONCLUSION: Age strongly decreases ovarian cancer mortality. This over mortality is only partly explained by later diagnosis and suboptimal treatment.