Abstract：
In the era of target therapy and personalized medicine, BRCA mutational status has a major influence on survival in ovarian cancer patients. Our aim is to verify if the poorer prognosis of elderly ovarian cancer patients can be related to the biology of the tumor beyond their own morbidities and/or suboptimal treatments.
This is a retrospective single-institution study evaluating prognosis of patients with a diagnosis of ovarian cancer and known BRCA status. We collected clinical and surgical characteristics and the distribution of BRCA mutational status according to age groups.
1840 patients were included in the analysis. The rate of BRCA mutated decreased over age-range from 49.7% in patients aged <50 years to 18.8% in ≥80 years old women. The prognostic role of BRCA status on survival is maintained when focusing on the elderly population, with improved Disease Free Survival (27.2 months vs 16.5 months for BRCA mutated and wild type respectively, p = 0.001) and Cancer Specific Survival (117.6 months vs 43.1 months for BRCA mutated and wild type respectively, p = 0.001) for BRCAmut compared to BRCAwt patients. In the multivariable analysis, among elderly women, upfront surgery and BRCA mutation are independent factors affecting survival.
Elderly patients experiment a poorer prognosis due to multiple factors that include both their medical condition and comorbidities, under-treatment and most importantly disease characteristics. We found that beyond disparities, BRCA mutation is still the strongest independent prognostic factor affecting both the risk of recurrence and death due to disease.
This is a retrospective single-institution study evaluating prognosis of patients with a diagnosis of ovarian cancer and known BRCA status. We collected clinical and surgical characteristics and the distribution of BRCA mutational status according to age groups.
1840 patients were included in the analysis. The rate of BRCA mutated decreased over age-range from 49.7% in patients aged <50 years to 18.8% in ≥80 years old women. The prognostic role of BRCA status on survival is maintained when focusing on the elderly population, with improved Disease Free Survival (27.2 months vs 16.5 months for BRCA mutated and wild type respectively, p = 0.001) and Cancer Specific Survival (117.6 months vs 43.1 months for BRCA mutated and wild type respectively, p = 0.001) for BRCAmut compared to BRCAwt patients. In the multivariable analysis, among elderly women, upfront surgery and BRCA mutation are independent factors affecting survival.
Elderly patients experiment a poorer prognosis due to multiple factors that include both their medical condition and comorbidities, under-treatment and most importantly disease characteristics. We found that beyond disparities, BRCA mutation is still the strongest independent prognostic factor affecting both the risk of recurrence and death due to disease.
摘要：
目的：在靶向治疗和个性化医疗的时代，BRCA突变状态对卵巢癌患者的生存有重要影响。我们的目的是验证老年卵巢癌患者的不良预后是否与肿瘤的生物学有关，超出了他们自己的发病率和/或欠佳的治疗方法。
方法：这是一项回顾性的单机构研究，评估诊断为卵巢癌和已知BRCA状态的患者的预后。我们根据年龄组收集临床和手术特征以及BRCA突变状态的分布。
结果：1840例患者被纳入分析。BRCA突变率在年龄范围内从<50岁患者的49.7%下降到≥80岁女性的18.8%。当关注老年人群时，BRCA状态对生存的预后作用得以维持。无病生存率提高（BRCA突变和野生型分别为27.2个月和16.5个月，p=0.001）和癌症特异性生存率（BRCA突变和野生型分别为117.6个月和43.1个月，与BRCAwt患者相比，BRCAmut的p=0.001）。在多变量分析中，在老年妇女中，前期手术和BRCA突变是影响生存率的独立因素.
结论：由于多种因素，包括医疗条件和合并症，老年患者的预后较差，治疗不足，最重要的是疾病特征。我们发现除了差异之外，BRCA突变仍然是影响疾病复发和死亡风险的最强独立预后因素。
方法：这是一项回顾性的单机构研究，评估诊断为卵巢癌和已知BRCA状态的患者的预后。我们根据年龄组收集临床和手术特征以及BRCA突变状态的分布。
结果：1840例患者被纳入分析。BRCA突变率在年龄范围内从<50岁患者的49.7%下降到≥80岁女性的18.8%。当关注老年人群时，BRCA状态对生存的预后作用得以维持。无病生存率提高（BRCA突变和野生型分别为27.2个月和16.5个月，p=0.001）和癌症特异性生存率（BRCA突变和野生型分别为117.6个月和43.1个月，与BRCAwt患者相比，BRCAmut的p=0.001）。在多变量分析中，在老年妇女中，前期手术和BRCA突变是影响生存率的独立因素.
结论：由于多种因素，包括医疗条件和合并症，老年患者的预后较差，治疗不足，最重要的是疾病特征。我们发现除了差异之外，BRCA突变仍然是影响疾病复发和死亡风险的最强独立预后因素。
