Objective: Ovarian cancer five-year survival is poor at < 40%. In the absence of effective screening or new treatments, ensuring all women receive optimal treatment is one avenue to improve survival. There is little population-based information regarding the primary chemotherapy treatment that women with epithelial ovarian cancer receive. This information is essential to identify potential gaps in care. Methods: Cancer registries identified all women diagnosed with invasive epithelial ovarian cancer in Australia in 2005 (n = 1192). Histopathology, chemotherapy and comorbidity information was abstracted from medical records. Multivariable logistic regression was used to identify factors associated with chemotherapy commencement, regimen, and completion. Results: Women > 70 years (p < 0.0001), those with high-grade, stage IA/IB cancers (vs. stages IC-IV, p = 0.003) and those with mucinous cancers (p = 0.0002) were less likely to start chemotherapy. Most treated women received platinum-based drugs (97%), but only 68% received combination carboplatin-paclitaxel and only half completed six cycles without treatment modification/delay. Approximately 19% received single-agent carboplatin: mostly those aged > 70 (p < 0.0001) and/or with co-morbidities (p < 0.0001). Age was the strongest predictor of completing six cycles of combination therapy. Conclusions: For specific patient groups, particularly older women, there is notable variation from standard treatment. Understanding how treatment variations affect survival and determining optimal regimens for these groups are research priorities.
Bibliographical noteFunding Information:
This work was supported by Cancer Australia (formerly National Breast and Ovarian Cancer Centre of Australia); National Health and Medical Research Council (NHMRC) of Australia (# 400281 , 400413 ); Cancer Councils of Victoria, Queensland, New South Wales, South Australia and Tasmania ; and Cancer Foundation of Western Australia . SJ and PW are supported by NHMRC Fellowships.
- Older women
- Ovarian cancer
- Patterns of care