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

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. (C) 2007 Elsevier Inc. All rights reserved.