Advanced epithelial ovarian cancer in older patients.
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Authors
Cullimore, Victoria
Gaitskell, Kezia
Newhouse, Rebecca
Baxter, Kathryn
Wood, Nicholas
Fotopoulou, Christina
Yap, Jason
MacDonald, Madeline
Edmondson, Richard J
Morrison, Jo
Issue Date
2025-07-22
Type
Journal Article
Language
en
Keywords
Chemotherapy , Cytoreductive Surgery , Epithelial Ovarian Cancer , Older Patients , Primary Treatment
Alternative Title
Abstract
Objective: We aimed to analyze management and survival outcomes of older patients (≥75 years) with stage ≥II epithelial ovarian cancer across gynecological cancer centers in the United Kingdom.
Methods: Retrospective cohort study performed using the IMPRESS project data set. Clinical information for patients diagnosed with epithelial ovarian cancer from 6 sites of varying size and population demographics was collated between January 2018 and December 2019. We compared treatment of patients aged ≥75 years with those <75, within and between centers, using multivariate analysis to understand effects on outcomes.
Results: After exclusions, we assessed 721 patients for overall survival and 702 for progression-free survival. Patients aged ≥75 years had poorer performance status and more comorbidities. Older patients were less likely to receive combination treatment with surgery and chemotherapy (in either order) (overall = 392/721 (54.4%); <75 cohort = 320/495 (64.6%); ≥75 cohort = 72/226 (31.9%), p < .0001). Treatment varied between sites, with some having no active treatment rates of 49% for patients aged ≥75 years. Older patients had twice the relative risk of death (relative risk 1.98, 95% CI 1.63 to 2.39, p < .001). Adjustment for confounders individually caused only a relatively modest reduction in magnitude and strength of association. Adjustment for treatment led to this association essentially disappearing (relative risk 1.10, 95% CI 0.88 to 1.38, 99% reduction in χ2), though with significant variation in association between age and overall survival between treatment groups (p-heterogeneity = .0004).
Conclusions: Older women may do as well as younger women in terms of survival if treated similarly, although this varies depending on treatment groups. Treatments varied between and within sites, with some sites treating older women differently than others.
Description
© 2025 The Author(s). Published by Elsevier Inc. on behalf of European Society of Gynaecological Oncology and the International Gynecologic Cancer Society.
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Citation
Cullimore, V. et al. (2025) 'Advanced epithelial ovarian cancer in older patients', International Journal of Gynecological Cancer. 35(10). Available at: https://doi.org/10.1016/j.ijgc.2025.102017
Publisher
Elsevier
License
Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.
Journal
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
Volume
35
Issue
10
PubMed ID
ISSN
1525-1438