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Poor outcome of elderly patients with platinum-sensitive recurrent ovarian cancer: Results from the SOCRATES retrospective study
Authors:Sandro  Gabriella Ferrandina  Giovanna Scarfone  Paolo Scollo  Franco Odicino  Gennaro Cormio  Dionyssios Katsaros  Luigi Frigerio  Liliana Mereu  Fabio Ghezzi  Luigi Manzione  Rossella Lauria  Enrico Breda  Desiderio Gueli Alletti  Michela Ballardini  Alessandra Vernaglia  Roberto Sorio  Salvatore Tumolo  Pietro Musso  Giovanna Magni  Carmela Pisano  Alessandro Morabito  
Institution:a Istituto Nazionale Tumori, Napoli, Italy
b Policlinico Agostino Gemelli, Ginecologia Oncologica, Roma, Italy
c Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Clinica Ostetrico-Ginecologica, Milano, Italy
d A.O. Cannizzaro, Ginecologia ed Ostetricia, Catania, Italy
e A.O. Ospedali Civili - Università degli Studi di Brescia, II Ginecologia ed Ostetricia, Brescia, Italy
f Azienda Ospedaliera Policlinico, II Ginecologia e Ostetricia, Bari, Italy
g Azienda Ospedaliera O.I.R.M.-S. Anna, Ginecologica Oncologica, Università di Torino, Italy
h Ospedali Riuniti di Bergamo, U.O. di Ginecologia, Bergamo, Italy
i Ospedale Policlinico S. Matteo, Ostetrica e Ginecologica, Pavia, Italy
j Ospedale F. Del Ponte, Clinica Ostetrica e Ginecologica, Università dell’Insubria, Varese, Italy
k Azienda Ospedaliera S. Carlo, Oncologia Medica, Potenza, Italy
l Università Federico II, Oncologia Medica, Napoli, Italy
m Ospedale S. Giovanni - Fatebene Fratelli - Isola Tiberina, Oncologia Medica, Roma, Italy
n A.O. Vincenzo Cervello, Ostetricia e Ginecologia, Palermo, Italy
o Ist. Onc.Romagnolo c/o Osp. Morgagni-Pierantoni, Forlì, Italy
p Casa di cura Malzoni, Ginecologia Oncologica, Avellino, Italy
q CRO AVIANO, Oncologia Medica, Aviano, Italy
r Azienda Ospedaliera S.Maria degli Angeli, Oncologia Medica, Pordenone, Italy
s Unità Operativa di Ginecologia Oncologica Ospedale Oncologico M. Ascoli Dipartimento Oncologico A.R.N.A.S. Palermo, Italy
t QBGROUP spa, Padova, Italy
Abstract:

Background

Elderly patients with ovarian carcinoma have a poorer prognosis compared with their younger counterpart, and this depends in most cases on undertreatment. The aim of this study was to evaluate, retrospectively, the pattern of care and the prognosis of elderly patients with platinum-sensitive recurrent ovarian cancer. The SOCRATES study retrospectively assessed the pattern of care of a cohort of patients with recurrent platinum-sensitive ovarian cancer observed in the years 2000-2002 in 37 Italian centres. Data were collected between April and September 2005.

Patients and methods

Patients with recurrent ovarian cancer with >6 months of platinum free interval were considered eligible. Four-hundred-ninety-three patient files were collected and 425 were considered eligible and analyzed. Ninety-four patients with age ≥70 years and 331 patients with age <70 years were analyzed.

Results

Recurrence free interval (RFI), PS, and number of disease sites were similar among the two groups. A lower proportion of elderly patients underwent secondary cytoreduction (8.9% compared to 23.9%; p = 0.0018). The mean number of chemotherapy lines received for recurrence was 2.7 and 2.5 in young and aged patients, respectively. Elderly patients received more frequently at second line single agent platinum than platinum-combination therapy or other non-platinum chemotherapy. The response rate to the second line chemotherapy was higher in younger patients than in the elderly population (CR + PR, younger: 67.2%; elderly: 46.5%; p = 0.0004). Median overall survival from recurrence was 30.7 months in the younger patients and 23.6 months in the elderly group (p = 0.0037). At multivariate analysis, number of disease sites (>1 vs. 1), performance status at recurrence (2-3 vs. 0-1), RFI (6-12 months vs. >12 months), age at recurrence, were independently associated with survival.

Conclusion

Elderly patients with platinum-sensitive recurrent ovarian cancer receive less surgery and chemotherapy. Response to chemotherapy is better in younger patients. Age is an unfavourable factor independently associated to a worst prognosis.
Keywords:Ovarian cancer  Recurrence  Elderly  Chemotherapy
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