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 (less than or equal to 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 less than or equal to 70 years. Older women presented more advanced stage and at equal stage A,ere 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. (C) 2004 Elsevier Ltd. All rights reserved.