Introduction

To explore differences in surgical complexity, chemotherapy administration, and treatment delays between younger and older Danish patients with epithelial ovarian cancer (EOC).

Materials and Methods

We included a nationwide cohort diagnosed with EOC from 2013 to 2018. We described surgical complexity and outcomes, the extent of chemotherapy and treatment delays stratified by age (<70 and ≥ 70 years), and surgical modality (primary, interval, or no debulking surgery).

Results

In total, we included 2946 patients. For patients with advanced-stage disease, 52% of the older patients versus 25% of the younger patients did not undergo primary debulking surgery (PDS) or interval debulking surgery (IDS). For patients undergoing PDS or IDS, older patients underwent less extensive surgery and more often had residual disease after surgery >0 cm compared to younger patients. Furthermore, older patients were less often treated with chemotherapy. Older patients had PDS later than younger. We did not find any differences between age groups concerning treatment delays. Two-year cancer-specific survival differed significantly between age groups regardless of curatively intended treatment.

Discussion

This study demonstrates that older patients are treated less actively concerning surgical and oncological treatment than younger patients, leading to worse cancer-specific survival. Older patients do not experience more treatment delays than younger ones.

中文翻译：

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手术和化疗时机对老年和年轻上皮性卵巢癌患者预后的影响：丹麦全国队列研究

介绍

探讨年轻和年老丹麦上皮性卵巢癌 (EOC) 患者在手术复杂性、化疗给药和治疗延迟方面的差异。

材料和方法

我们纳入了一个从 2013 年到 2018 年被诊断患有 EOC 的全国队列。我们描述了手术的复杂性和结果、化疗的程度和按年龄（<70 岁和≥70 岁）分层的治疗延迟，以及手术方式（主要、间隔或不减瘤）外科手术）。

结果

我们总共纳入了 2946 名患者。对于晚期疾病患者，52% 的老年患者和 25% 的年轻患者没有接受初次减瘤手术 (PDS) 或间隔减瘤手术 (IDS)。对于接受 PDS 或 IDS 的患者，与年轻患者相比，老年患者接受的手术范围较小，并且术后残留病灶 > 0 cm 的可能性更大。此外，老年患者较少接受化疗。老年患者患 PDS 的时间晚于年轻患者。我们没有发现年龄组之间在治疗延迟方面存在任何差异。无论治疗目的如何，不同年龄组的两年癌症特异性生存率存在显着差异。

讨论

这项研究表明，与年轻患者相比，老年患者在手术和肿瘤治疗方面的积极性较低，导致癌症特异性生存率更差。老年患者不会比年轻患者经历更多的治疗延误。