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The approach to ovarian cancer in older women

William P Tew, MD
Kathleen M Moore, MD
Section Editors
Barbara Goff, MD
Don S Dizon, MD, FACP
Deputy Editor
Sadhna R Vora, MD


Cancer is recognized as a disease of older adults, with over 50 percent of new cases being diagnosed after age 65, and over 70 percent of deaths from cancer occurring in this same age group [1,2]. Ovarian cancer is the seventh most common cancer in women worldwide and accounts for nearly 4 percent of all new cases of cancer in women [3]. It is also the eighth most common cause of cancer death in the world. The risk of ovarian cancer increased with age with only 10 to 15 percent of cases diagnosed before menopause [3]. With increasing age, there is an increased prevalence of comorbid conditions, polypharmacy, functional dependence, cognitive impairment, depression, frailty, poor nutrition, and limited social support [4]. Given these many potential limitations, it is not surprising that many older adult patients who present with advanced ovarian cancer receive less aggressive therapies than their younger counterparts and have poorer disease-specific outcomes. Because there are limited data on the approach to older women with gynecologic cancer in general, this topic will specifically discuss the care of the older woman with ovarian cancer.

Other topics related to the cancer care of this population are discussed separately. (See "Comprehensive geriatric assessment for patients with cancer" and "Treatment of metastatic breast cancer in older women" and "Drug prescribing for older adults" and "Hospital management of older adults" and "Systemic chemotherapy for cancer in elderly persons" and "Adjuvant therapy for resected colon cancer in elderly patients" and "Therapy for metastatic colorectal cancer in elderly patients and those with a poor performance status" and "Palliative care: Issues specific to geriatric patients".)


Older patients should undergo a geriatric assessment (GA) at their initial presentation to determine whether or not they are appropriate candidates for cytoreductive surgery (CRS). (See 'Geriatric assessment' below.)

The results of the assessment can be used to determine the most appropriate treatment strategy:

Patients who are candidates for CRS should proceed with primary surgical therapy. (See 'Approach to surgery' below.)

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Literature review current through: Nov 2017. | This topic last updated: Aug 21, 2017.
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