Age-specific differences in treatment and survival of ovarian cancer patients in the province of Limburg, the Netherlands, 1986-92

Abstract

de Rijke JM, Schouten LJ, Volovics A, van der Putten HWHM. Age-specific differences in treatment and survival of ovarian cancer patients in the province of Limburg, the Netherlands, 1986–92. Int J Gynecol Cancer 1998; 8: 150–157. The objective of this study was to investigate age-specific differences in treatment and survival of patients with epithelial ovarian cancer diagnosed in the period 1986–92 in Middle and Southern Limburg, the Netherlands. Data about the treatment of epithelial ovarian cancer patients were derived from the population-based Maastricht Cancer Registry and retrospectively evaluated. Observed and relative survival rates were calculated according to age, stage, period of incidence and histology. Differences in survival between three age groups were explored with univariate and multivariate analyses. The patients were followed until January 1, 1994. The total study group comprised 367 epithelial ovarian cancer patients; 86 were younger than 55 years at diagnosis, 152 were 55–69 years and 129 were aged 70 years or older. Stage III (FIGO) was the most common stage at diagnosis in the three age groups. Older women (70 +) were more likely to have received no treatment or only one treatment modality than were younger women (P < 0.001). Five-year relative survival decreased with age: 54%, 34% and 17% in the three age groups 0–54, 55–69 and 70 + years, respectively (P= 0.000). Multivariate regression analysis revealed that age at diagnosis was an independent significant prognostic factor. Several exposure factors in elderly women may explain the differences in treatment and survival, such as additional comorbid conditions, more aggressive tumor growth, physicians' reluctance to treat elderly patients and less favorable social conditions.