The influence of age and co-morbidity on treatment and prognosis of ovarian cancer: a population-based study
The influence of age and co-morbidity on treatment and prognosis of ovarian cancer: a population-based study
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DOI：
10.1016/j.ygyno.2004.12.026
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发表时间：
2005-04-01
影响因子：
4.7
通讯作者：
Janssen-Heijnen, MLG
中科院分区：
文献类型：
--
作者：
Maas, HAAM;Kruitwagen, RFPM;Janssen-Heijnen, MLG
目标.随着平均年龄的增加，更多的患者在诊断卵巢癌时患有一种或多种其他严重疾病（共病）。在这项研究中，年龄和合并症的治疗指南的应用和预后的独立影响进行了评估。所有在1995年至2001年间诊断为上皮性卵巢癌的荷兰南部患者（N = 1116）均纳入研究。合并症的患病率从< 70岁年龄组的34%增加到老年组的63%。在70岁以下的FIGO II期或III期患者中，有83%接受了建议的治疗（手术和化疗的结合），而70岁或以上的患者中只有45%接受了建议的治疗。在多变量分析中，年龄、FIGO分期、合并症的存在和诊断年份似乎是接受建议治疗的独立预测因素。在多变量分析中，年龄70岁以上（HR = 1.3，95%CI = 1.03-1.7）和同时使用手术和化疗（HR = 0.4，95%CI = 0.3-0.6，仅参考手术）是影响总生存率的独立预后因素。即使在没有合并症的情况下，FIGO II或III型卵巢癌老年患者的标准联合治疗也明显较少。年龄、手术联合铂类化疗是独立的预后因素。合并症似乎没有预后影响。(c)2004爱思唯尔公司All rights reserved.
Objectives. With the rising mean age, more patients will have one or more other serious diseases at the time of diagnosis of ovarian cancer (co-morbidity). In this study, the independent effects of age and co-morbidity on the application of treatment guidelines and prognosis were evaluated.Methods. All patients with epithelial ovarian cancer diagnosed between 1995 and 2001 in the southern part of The Netherlands (N = 1116) were included.Results. The prevalence of co-morbidity increased from 34% of the age group < 70 to 63% of the older age group. Eighty-three percent of the patients with FIGO stage II or stage III younger than 70 years underwent the advised treatment (combination of surgery and chemotherapy) compared to only 45% of the patients aged 70 or older. In a multivariable analysis age, FIGO stage, presence of co-morbidity, and year of diagnosis seemed to be independent predictors of receiving the advised treatment. In multivariable analyses age 70 + (HR = 1.3, 95% CI = 1.03-1.7) and the use of both surgery and chemotherapy (HR = 0.4, 95% CI = 0.3-0.6, reference is only surgery) were independent prognostic factors for overall survival.Conclusions. Even in the absence of co-morbidity, standard combination therapy was prescribed significantly less often for elderly patients with FIGO II or III ovarian cancer. Age and combined treatment of surgery and platinum-based chemotherapy were independent prognostic factors. Co-morbidity did not seem to have a prognostic effect. (c) 2004 Elsevier Inc. All rights reserved.