Aggressive tx for ovarian ca in elderly doesn't raise morbidity.(Gynecology)

RANCHO MIRAGE, CALIF. -- Aggressive surgery for epithelial ovarian cancer did not increase mortality or morbidity, compared with less aggressive surgery in patients over age 65 or with medical comorbidities, a review of 140 cases found.

Some surgeons are hesitant to pursue cytoreductive surgery in these kinds of patients as aggressively as they might in patients with fewer surgical risk factors because of previous data showing poorer survival rates in older women.

Federal data show that older patients with cancer are less likely to be treated surgically.

In the current study, only the amount of ovarian tumor removed was associated with survival, Sameer Sharma, M.D., said at the annual meeting of the Society of Gynecologic Surgeons.

Surgery reduced the tumor to less than 1 cm in diameter (considered "optimal debulking") in 88% of patients. Patients with optimal debulking survived a median of 52 months, compared with 26 months for patients with more tumor left after surgery, said Dr. Sharma of the Roswell Park Cancer Institute, Buffalo, N.Y.

There appears to be no significant difference in survival based on age alone, which contradicts previous findings, Dr. Sharma reported.

There were no significant differences in survival or in the rate of complications during or after surgery among the 24% of patients who underwent standard debulking surgery, the 57% who had radical debulking surgery, or the 19% who underwent supraradical debulking surgery.