Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 7;24(1):100.
doi: 10.1186/s12905-024-02938-y.

Disparities in treatment modalities and survival among older patients with high-grade serous ovarian cancer

Yan Cai  1 , Tong Shu  1 , Hong Zheng  2
Affiliations

Disparities in treatment modalities and survival among older patients with high-grade serous ovarian cancer

Yan Cai et al. BMC Womens Health. .

Abstract

Background: Undertreatment of ovarian cancer is common among older women. We aimed to evaluate the treatment modalities offered to older patients and their impact on overall survival (OS).

Methods: The study identified 5,055 patients with high-grade serous ovarian cancer and 3584 patients with advanced stage (IIIC + IV) disease from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010, to December 31, 2017. We performed comparisons of OS and ovarian cancer-specific survival (OCSS) across age groups using a Cox proportional hazards model.

Results: Very elderly patients (≥ 75 years old) received treatment with significantly less surgical complexity, such as no lymphadenectomy (59.7% vs. 48.6%; p < 0.001) and a lower rate of optimal debulking surgery (44.0% vs. 52.7%; p < 0.001), as well as lower rates of chemotherapy (78.2% vs. 89.4%; P<0.001) and standard treatment (70.6% vs. 85%; p < 0.001). High proportions of both very elderly and elderly patients received neoadjuvant chemotherapy (NACT), with no significant difference (38.7% vs. 36.2%; P = 0.212). Patients aged ≥ 75 years had significantly worse OS and OCSS.

Conclusion: With increasing age, the survival rate of women with ovarian cancer decreases significantly. Noticeably fewer ovarian cancer patients aged over 75 years receive standard treatments, and more very elderly patients are treated with NACT.

Keywords: Chemotherapy; High-grade serous ovarian cancer; Older patients; Surgery; Treatment disparities.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Overall survival and ovarian cancer (OC) specific survival by age group of all patients (A); Overall survival and ovarian cancer (OC) specific survival by age group of advanced stage patients (B). The number at risk in the weighted dataset is shown
Fig. 2
Fig. 2
Stratified survival analyses by treatment group. (A) Overall survival of all advanced stage patients. (B) Overall survival of the elderly group. (C) Overall survival of the very elderly group. Abbreviations: Che + Sur, chemotherapy + surgery; Che, chemotherapy; Sur, surgery
Fig. 3
Fig. 3
Stratified survival analyses by residual disease. (A) Overall survival of all advanced stage patients. (B) Overall survival of the elderly group. (C) Overall survival of the very elderly group. Abbreviations: PDS, primary debulking surgery and IDS, interval debulking surgery
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73:17–48. doi: 10.3322/caac.21763. - DOI - PubMed
    1. Wright JD, Chen L, Tergas AI, Patankar S, Burke WM, Hou JY, et al. Trends in relative survival for ovarian cancer from 1975 to 2011. Obstet Gynecol. 2015;125:1345–52. doi: 10.1097/AOG.0000000000000854. - DOI - PMC - PubMed
    1. Tew WP. Ovarian cancer in the older woman. J Geriatric Oncol. 2016;7:354–61. doi: 10.1016/j.jgo.2016.07.008. - DOI - PubMed
    1. Moschetta M, Boussios S, Rassy E, Samartzis EP, Funingana G, Uccello M. Neoadjuvant treatment for newly diagnosed advanced ovarian cancer: where do we stand and where are we going? Ann Transl Med. 2020;8:1710. doi: 10.21037/atm-20-1683. - DOI - PMC - PubMed
    1. Horowitz NS, Miller A, Rungruang B, Richard SD, Rodriguez N, Bookman MA, et al. Does aggressive surgery improve outcomes? Interaction between preoperative disease burden and complex surgery in patients with advanced-stage ovarian cancer: an analysis of GOG 182. J Clin Oncology: Official J Am Soc Clin Oncol. 2015;33:937–43. doi: 10.1200/JCO.2014.56.3106. - DOI - PMC - PubMed

Publication types