The old age itself is not an independent poor prognostic factor in epithelial ovarian cancer (EOC)

Abstract

Background: The speed of aging of Korea is the highest in the world. Previous studies about the relationship between age and EOC have shown inconsistent results and almost all of them have been from western countries. The aims of this study were to demonstrate the effect of old age (age ≥65) on the clinic-pathologic factors and survivals in Korean patients with EOC. Methods: After a retrospective chart review of 486 EOC patients including 70 elderly patients who underwent surgery for EOC between January 2000 and February 2010, we compared the demographics, surgical outcomes, clinic-pathologic factors, chemotherapy administered and survivals of younger versus older patients. Results: Mean age of younger (n=416) and older (n=70) groups were 47 (range, 14-64) and 70 (range, 65-84), respectively. The characteristics which were different between two groups were as follows: body mass index (kg/m2), 22.8±3.4 vs. 24.1±3.6, p=0.002; cardiovascular diseases, 46 (11.1%) vs. 44 (62.9%), p=0.000; diabetes mellitus, 18 (4.3%) vs. 15 (21.4%), p=0.000; stage, p=0.012; Clear cell carcinoma histologic type, 55 (13.2%) vs. 3 (4.3%), p=0.029; Omentum involvement, 169 (48.1%) vs. 43 (66.2%), p=0.000; Ascites cytology, 216 (53.5%) vs. 42 (62.7%), p=0.012. On the contrary, optimal debulking rate, recur rate, lines of chemotherapy, total courses of chemotherapy, 1-year progression free survival (51.6% vs. 58.8%, p=0.450) and 5-year overall survival (83.5% vs. 76.0%, p=0.525) were all similar between two groups. Cox regression analyses failed to show any of the characteristics which were shown to be different between groups but stage might have confounding effects on the age and survival relationship. Conclusions: If optimal debulking and chemotherapy statuses are the same, old age itself is not an independent poor prognostic factor despite the higher stage of older patients. Therefore, maximal effort should be directed towards optimal debulking surgery and chemotherapy for elderly EOC patients.