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Interval Debulking Surgery for Advanced Ovarian Cancer in Elderly Patients (≥70 y): Does the Age Matter?
Pinelli, Ciro; Morotti, Matteo; Casarin, Jvan; Tozzi, Roberto; Ghezzi, Fabio; Mavroeidis, Vasileios K; Alazzam, Moiad; Soleymani Majd, Hooman.
Afiliação
  • Pinelli C; Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.
  • Morotti M; Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy.
  • Casarin J; Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.
  • Tozzi R; Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.
  • Ghezzi F; Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy.
  • Mavroeidis VK; Department of Gynaecologic Oncology, Oxford University Hospital NHS Trust, Churchill Hospital, Oxford, UK.
  • Alazzam M; Department of Obstetrics and Gynaecology, University of Insubria, Varese, Italy.
  • Soleymani Majd H; Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK.
J Invest Surg ; 34(9): 1023-1030, 2021 Sep.
Article em En | MEDLINE | ID: mdl-32148117
ABSTRACT

BACKGROUND:

Elderly ovarian cancer (OC) patients are more likely to be managed suboptimally, with worse clinical outcomes as a result. Strategies to decrease morbidity are lacking.

Methodology:

Consecutive patients with advanced stage OC (IIIC-IV) who were managed in our center between January 2016 and July 2018 were retrospectively analyzed. All patients underwent neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) according to our institution protocol. We divided patients into two groups Group 1 (age ≥ 70 years) and Group 2 (age < 70 years). The primary outcome of the study was assessment of peri-operative morbidity amongst two groups.

RESULTS:

A total of 153 patients were referred during the study period. 114 patients underwent IDS after NACT (74.5%), 46 in Group 1 and 68 in Group 2. Elderly patients were more likely to receive more than three cycles of NACT prior to IDS compared to younger patients (39% vs. 19%, p = 0.03). Elderly patients were more frequently subjected to Cardiopulmonary Exercise Testing (CPET) as pre-operative assessment (63% vs. 27%, p = 0.002). Optimal/complete resection was achieved in all patients in Group 1 (100%) and in 97% of patients in Group 2. With the exception of higher postoperative cardiac arrhythmias in Group 1 (11% vs. 1%, p = 0.04), no significant differences in 30-day morbidity were observed. No 90-day death in both groups was registered.

CONCLUSION:

Older age should not preclude clinicians from offering ultra-radical resection to patients with advanced OC after NACT. In our series, elderly patients received the same treatment with similar outcomes to the younger group. Clinicians should be encouraged to use CPET for patients' selection following NACT.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Procedimentos Cirúrgicos de Citorredução Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Procedimentos Cirúrgicos de Citorredução Idioma: En Ano de publicação: 2021 Tipo de documento: Article