AGE-SPECIFIC DIFFERENCES IN TREATMENT AND SURVIVAL OF OVARIAN-CANCER PATIENTS IN THE PROVINCE OF LIMBURG, THE NETHERLANDS, 1986-92

The objective of this study was to investigate age-specific difference s in treatment and survival of patients with epithelial ovarian cancer diagnosed in the period 1986-92 in Middle and Southern Limburg, the N etherlands. Data about the treatment of epithelial ovarian cancer pati ents were derived from the population-based Maastricht Cancer Registry and retrospectively evaluated. Observed and relative survival rates w ere calculated according to age, stage, period of incidence and histol ogy. Differences in survival between three age groups were explored wi th univariate and multivariate analyses. The patients were followed un til January 1, 1994. The total study group comprised 367 epithelial ov arian cancer patients; 86 were younger than 55 years at diagnosis, 152 were 55-69 years and 129 were aged 70 years or older. Stage III (FIGO ) was the most common stage at diagnosis in the three age groups. Olde r women (70 +) were more likely to have received no treatment or only one treatment modality than were younger women (P < 0.001). Five-year relative survival decreased with age: 54%, 34% and 17% in the three ag e groups 0-54, 55-69 and 70 + years, respectively (P = 0.000). Multiva riate regression analysis revealed that age at diagnosis was an indepe ndent significant prognostic factor. Several exposure factors in elder ly women may explain the differences in treatment and survival, such a s additional comorbid conditions, more aggressive tumor growth, physic ians' reluctance to treat elderly patients and less favorable social c onditions.