- Neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery (CRS) improves OS vs chemotherapy alone in patients aged ≥75 years with ovarian cancer, including those aged >80 years with advanced disease and comorbidities.
- Use of NACT+interval CRS increased over time.
Why this matters
- Postoperative morbidity and mortality risks are higher in older patients; individualized treatment may improve outcomes in these patients.
- 1661 patients (age, ≥75 years) with ovarian cancer received NACT+interval CRS (n=700) or chemotherapy alone (n=961) during 2004-2014.
- Funding: Fisher Family Fund; Denise Hale Chair fund; the San Francisco Women’s Leadership Group.
- Use of NACT increased from 28% to 50% from 2004-2007 to 2012-2014 (P<.001>
- Median follow-up was 23 months.
- 5-year OS was 14%.
- OS was significantly higher with NACT vs chemotherapy alone (25% vs 7%; HR, 0.44; P<.001>
- OS benefit with NACT was maintained in patients aged >80 years, with stage III-IV disease and ≥1 comorbidities (HR, 0.28; P<.001>
- OS was significantly worse in:
- older patients (age, 80-84 vs 75-79 years; HR, 1.35; P=.002); and
- advanced vs early-stage disease (HR, 2.06; P=.001).
- Retrospective design.