Surgery, chemo best for elderly with advanced ovarian cancer

(HealthDay)—Primary debulking surgery and chemotherapy in an optimal timeframe is associated with the longest survival time for elderly women with advanced ovarian cancer, according to a study published in the January issue of Obstetrics & Gynecology.

Jenny J. Lin, M.D., M.P.H., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a retrospective cohort study to examine trends in treatment and overall survival for 7,938 women older than 65 years with stage III and IV epithelial ovarian cancer, diagnosed between 1995 and 2008. Overall, 2.9 percent of women received no treatment and 15.4 and 24.8 percent, respectively, underwent surgery or chemotherapy alone, while 41.8 percent underwent primary debulking surgery and chemotherapy in an optimal time frame (optimal treatment). In addition, 15.1 percent of women underwent primary debulking surgery and chemotherapy, but either the timing was not optimal or all six chemotherapy cycles were not completed.

The researchers found that survival was similar for those who underwent surgery only versus no treatment (2.2 versus 1.7 months); better overall survival was seen for those who received chemotherapy only (14.4 months). The longest survival time was seen for those with optimal treatment (median overall survival, 39.0 months; P < 0.001). Over the past decade, survival time associated with optimal treatment increased. However, over the past decade there was a decrease in the proportion of women who received optimal treatment.

"Elderly women with advanced ovarian cancer have the best survival with optimal therapy," the authors write. "When this is not offered or possible, chemotherapy alone offers better survival than surgery alone."

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