Epithelial ovarian cancer in the elderly: The memorial sloan‐kettering cancer center experience

Background. There is evidence of differences between older (≥ 65 years of age) and younger (< 65 years of age) women with ovarian cancer. Methods. To evaluate differences in the care of older versus younger patients with ovarian cancer, a retrospective review was conducted of the records of 146 patients who had their initial surgery for ovarian cancer at the Memorial Sloan‐Kettering Cancer Center from January 1987–January 1991. Results. There was a significant difference in stage at presentation between the older (48 patients) and younger (98 patients) populations (Stage I/II: older 10%; younger 25%; P < 0.05). Although there was no statistically significant difference in the distributions of patients according to tumor grade between the two groups, 10% of the younger patients had ovarian cancer of low malignant potential, compared to only 2% of older patients (P < 0.1). Forty‐six percent of the younger patients entered an intensive initial chemotherapy trial compared to only 17% of the older patients (P < 0.001), principally due to comorbid medical conditions (e.g., heart disease). Finally, whereas the relative number of younger to older patients with ovarian cancer undergoing initial surgery at this institution was 2:1, the relative number of totally new patients to the service (including referral for initial treatment or salvage programs) was 4:1 (P < 0.001), suggesting that older patients with ovarian cancer are less likely to be referred for secondary experimental programs than for initial treatment. Conclusions. These data suggest that there are major differences between the presentation and treatment strategies of older compared to younger patients with ovarian cancer.