Ovarian cancer in the elderly: What is retained after the International Conference of Vancouver? [Cancer épithélial évolué de l'ovaire de la patiente agée: Quel état des lieux suite à la Conférence internationale de Vancouver?]

摘要

Introduction: We have not enough knowledge on the standard treatments of ovarian cancer in the elderly, in terms of feasibility, tolerance and efficacy, because of their relative under representation in clinical trials. Discussion: The standard treatment of ovarian cancer is radical surgery followed by chemotherapy. However, there is a small proportion of elderly women in clinical trials and the real efficacy of standard, platinum/taxanes-based chemotherapy, is not precisely defined. It is necessary to integrate co-morbidity and vulnerability of the elderly persons, to better anticipate which kind of chemotherapy and surgery should be performed and for which patients, by combining, as in the PACE study for example, tools of evaluation of the surgical risks with components of the geriatric assessment. Conclusion: Currently available data allows us to discriminate between "fit" and "frail" patients; the former being able to tolerate standard procedures, and the latter being at higher risk of toxicity and impaired life-expectancy. Different questions should be asked in collaborative trials for each population, respectively.