Response and outcomes in elderly patients with stages IIIC–IV ovarian cancer receiving platinum–taxane chemotherapy

Abstract

Objective. Recent reports have suggested that only half of women age ≥ 65 with advanced ovarian cancer are treated with platinum-based chemotherapy. The objective of this study was to compare the response to platinum–taxane chemotherapy and subsequent outcomes between patients older and younger than 65 years of age with stages IIIC–IV epithelial ovarian cancer (EOC). Patients and methods. A cohort study was performed of all patients with stages IIIC–IV EOC who had their primary surgery at our institution from 1998 to 2004 and subsequently began platinum–taxane chemotherapy. Main outcomes were response to primary chemotherapy, platinum resistance and progression-free (PFS) and overall survival (OS). Results. A total of 292 patients began primary platinum–taxane therapy after surgery and comprised our study group. Of these, 108 (37%) were ≥ 65 years old and 184 (63%) were < 65. Stage of disease, optimal cytoreduction rate, number of chemotherapy cycles and chemotherapy regimen alterations were similar between groups. Patients ≥ 65 achieved a clinical complete response with a similar frequency to those < 65 (70% vs. 79%) and had similar rates of platinum sensitivity at 6 months (61% vs. 65%). Patients ≥ 65 had equivalent PFS ( P = 0.99) and OS ( P = 0.36) to those < 65. Age ≥ 65 years was not independently associated with impaired survival. Conclusions. Patients ≥ 65 years of age demonstrated similar rates of initial response, platinum resistance, PFS and OS to younger patients. Elderly women who can tolerate primary cytoreductive surgery should receive combination platinum–taxane chemotherapy.