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Annals of Oncology Advance Access originally published online on August 10, 2005
Annals of Oncology 2005 16(11):1795-1800; doi:10.1093/annonc/mdi368
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© 2005 European Society for Medical Oncology

Comprehensive geriatric assessment predicts tolerance to chemotherapy and survival in elderly patients with advanced ovarian carcinoma: a GINECO study

G. Freyer1,*, J.-F. Geay2, S. Touzet3, J. Provencal4, B. Weber5, J.-P. Jacquin6, G. Ganem7, N. Tubiana-Mathieu8, O. Gisserot9, E. Pujade-Lauraine2 for the Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO)

1 Service d'oncologie médicale, Centre Hospitalier Lyon Sud, Pierre-Bénite; 2 Service d'oncologie médicale, Hôtel Dieu, Paris; 3 Département d'information médicale, Hospices Civils de Lyon, Lyon; 4 Service d'oncologie médicale, Centre Hospitalier Universitaire, Grenoble; 5 Service d'oncologie médicale, Centre Alexis-Vautrin, Vandoeuvre-les-Nancy; 6 Institut cancérologique de la Loire, Saint-Etienne; 7 Service d'oncologie médicale, Clinique Jean Bernard, le Mans; 8 Service d'oncologie médicale, Hôpital universitaire Dupuytren, Limoges; 9 Service d'oncologie médicale, Hôpital d'Instruction des Armées Ste Anne, Toulon Naval, France

* Correspondence to: Dr G. Freyer, Medical Oncology Department, Centre Hospitalier Lyon Sud, 69495 Pierre-Bénite Cedex, France. Tel: +33-47-88-64-318; Fax: +33-47-88-64-319; E-mail: gilles.freyer{at}chu-lyon.fr

Background: Data from prospective clinical trials are needed to better define standards of care in elderly patients with advanced ovarian carcinoma and to demonstrate the interest of Comprehensive Geriatric Assessment (CGA) in this fragile and heterogeneous population.

Patients and methods: From July 1998 to October 2000, 83 advanced ovarian carcinoma patients >70 years old received carboplatin AUC 5 and cyclophosphamide 600 mg/m2, on day 1 of six 28-day cycles. The clinical and biological geriatric covariates prospectively studied were: comorbidities, comedications, cognitive functions (Mini-Mental test), nutritional status and autonomy.

Results: Patient characteristics were: median age 76 years, serous histology (73%), FIGO stage III (75%), optimal initial surgery (21%) and performance status (PS) ≥2 (44%). Sixty patients (72%) received six chemotherapy cycles without severe toxicity (STox) or tumor progression. Multivariate analysis retained three factors as independent predictors of STox: symptoms of depression at baseline (P = 0.006), dependence (P = 0.048) and PS ≥2 (P = 0.026). Independent prognostic factors identified for overall survival (Cox model) were depression (P = 0.003), FIGO stage IV (P = 0.007) and more than six different comedications per day (P = 0.043).

Conclusion: CGA could predict STox and overall survival of elderly advanced ovarian carcinoma patients.

Key words: chemotherapy, elderly, geriatric assessment, ovarian cancer


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