Older girls with ovarian most cancers could profit from extra aggressive therapy

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January 14, 2021

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Disclosure:
Gushchin does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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According to a study published in Annals of Surgical Oncology, advance cytoreductive surgery as well as hyperthermic intraperitoneal chemotherapy may be a viable treatment for certain older women with ovarian cancer.

“There has been a constant debate among oncologists about how much treatment is too much.” Vadim Gushchin, MD, FACS, The surgical oncologist and director of the Hyperthermic Intraperitoneal Chemotherapy (HIPEC) program at the Institute for Cancer Treatment at Mercy, Baltimore, said Healio. “Ovarian cancer is common in older women. We often wonder whether we should offer aggressive treatment modalities such as cytoreduction and HIPEC to our elderly patients, whether the treatment is effective in these women, and whether older women have more complications after these complex treatments. Our study suggests that the life expectancy of patients receiving cytoreduction plus HIPEC for ovarian cancer was similar regardless of age, and older women recovered well from this aggressive treatment. “

The results showed the longest median OS in women treated with pre-cytoreductive surgery plus HIPEC.

The results showed the longest median OS in women treated with pre-cytoreductive surgery plus HIPEC.

There is no consensus on the best treatments for women 65 and over with epithelial ovarian cancer.

Vadim Gushchin, MD, FACS

Vadim Gushchin

Gushchin and colleagues attempted to evaluate the results of cytoreductive surgery plus HIPEC in women with epithelial ovarian cancer between 1998 and 2019 in a prospective database. They compared perioperative variables after treatment, including cytoreductive surgery plus HIPEC (n = 42), neoadjuvant chemotherapy plus cytoreductive surgery and HIPEC (n = 48) and cytoreductive salvage surgery plus HIPEC (n = 58), and age at surgery (<65 years of age and 65 years).

The median follow-up was 44.6 months.

The results showed the longest median OS in women pre-treated with cytoreductive surgery plus HIPEC – 69.2 months for those under 65 and 69.3 months for those over 65.

The median OS for women treated with neoadjuvant chemotherapy plus cytoreductive surgery and HIPEC was 26.9 months for subjects under 65 years of age versus 32.9 months for subjects 65 and over and 45.6 months versus 23.9 months for patients with cytoreductive salvage surgery plus HIPEC.

The median PFS was also longer in women who received prior cytoreductive surgery plus HIPEC – 41.3 months for people under 65 versus 45.4 months for people 65 and over – compared to women who received neoadjuvant chemotherapy plus cytoreductive Surgery and HIPEC received (16.2 months vs. 11.2 months) or cytoreductive recovery surgery plus HIPEC (18.7 months vs. 10 months).

The researchers observed no deaths in people under 65 years of age, compared with a 30-day death rate of 8.3% and a 90-day death rate of 13.3% in those over 65 years of age.

“Caring for the elderly requires additional skills and resources,” said Gushchin. “We will continue our efforts to quantify these requirements so that our results can be applied to other institutions. We also plan to investigate how age factors co-exist with molecular prognostic factors in ovarian cancer. These data could enable us to better select patients for different treatments. “

For more informations:

Vadim Gushchin, MD, FACS, reachable at the Institute for Cancer Treatment at Mercy, 227 Saint Paul Place, 4th Floor Vineyard Building, Baltimore, MD 21202; Email: vgushchin@mdmercy.com.

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Ovarian Cancer Advanced Robotic Surgery

If you want to learn more about the availability of robotic surgery in advanced ovarian cancer, this is a resource to explore in Southern California:  Robotic Surgery Ovarian Cancer 

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