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

Area of Science:

• Oncology
• Geriatric Medicine
• Cancer Epidemiology

Background:

• Overtreatment of ovarian cancer is a significant issue in older women.
• Treatment disparities may affect survival outcomes in elderly ovarian cancer patients.
• Understanding age-related treatment variations is crucial for improving geriatric oncology care.

Purpose of the Study:

• To evaluate treatment modalities in older ovarian cancer patients.
• To assess the impact of these treatments on overall survival (OS) and ovarian cancer-specific survival (OCSS).
• To identify survival differences across age groups in ovarian cancer patients.

Main Methods:

• Analysis of 5,055 high-grade serous ovarian cancer patients from the SEER database (2010-2017).
• Inclusion of 3,584 patients with advanced stage (IIIC+IV) disease.
• Comparison of OS and OCSS using Cox proportional hazards models across age groups.

Main Results:

• Very elderly patients (≥75 years) received less complex surgery (e.g., no lymphadenectomy, lower optimal debulking rates).
• Elderly patients had lower rates of chemotherapy and standard treatment compared to younger groups.
• Patients aged ≥75 years experienced significantly worse OS and OCSS.

Conclusions:

• Increasing age is associated with a significant decrease in ovarian cancer survival rates.
• Very elderly patients (≥75 years) are less likely to receive standard treatments and more likely to receive neoadjuvant chemotherapy (NACT).
• Age-related treatment disparities contribute to poorer survival outcomes in older women with ovarian cancer.