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. 2019 Jan;30(1):e11.
doi: 10.3802/jgo.2019.30.e11. Epub 2018 Oct 22.

Optimal cutoff age for predicting prognosis associated with serous epithelial ovarian cancer: what is the best age cutoff?

Jihye Kim #  1 , Youjean Chang #  1 , Tae Joong Kim  1 , Jeong Won Lee  1 , Byoung Gie Kim  1 , Duk Soo Bae  1 , Chel Hun Choi  2
Affiliations

Optimal cutoff age for predicting prognosis associated with serous epithelial ovarian cancer: what is the best age cutoff?

Jihye Kim et al. J Gynecol Oncol. 2019 Jan.

Abstract

Objective: Elderly age is one of the poor prognostic factors in epithelial ovarian cancer (EOC), but the optimal age cut-off is not known. The present study sought to identify the ideal age cutoff that represents a negative prognostic factor in EOC, considering the geriatric assessment.

Methods: Hazard ratios (HRs) with p-values were calculated using all possible age cutoffs with stage, histology, grade, optimality and comorbidities as covariates in multivariate Cox regression model. The trends of p-value and HR by age cutoff were further evaluated in a subgroup of histology and in The Cancer Genome Atlas (TCGA) dataset. In addition, propensity score-matching analysis using the identified age cutoff was performed.

Results: An age of 66 years was shown to be the most significant cutoff for defining old age with independent prognostic power (HR=1.45; 95% confidence interval=1.04-2.03; p=0.027). This result was also observed with the analyses of serous histology subgroup and with the analysis of a TCGA dataset with serous EOC. In survival analysis, patients aged ≥66 years had significantly worse overall survival compared with younger individuals (56 months vs. 87 months; p=0.006), even following propensity score matching (57 vs. 78 months; p=0.038).

Conclusion: An age of 66 years is the best cutoff to define elderly age in serous EOC patients considering the geriatric assessment, and this information can be used in the administration of individualized therapies in elderly EOC patients.

Keywords: Elderly; Epithelial Ovarian Cancer; Geriatric Assessment; Prognosis; Propensity Score-Matching.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. (A) HRs and p-values of Cox regression using age as a dichotomous cutoff of EOC patients in Samsung Medical Center. (B) Age-specific OS analysis with patients aged <66 years or ≥66 years.
EOC, epithelial ovarian cancer; HRs, hazard ratios; OS, overall survival.
Fig. 2
Fig. 2. (A) HRs and p values of Cox regression analysis in serous histologic subtype using age as a dichotomous cutoff. (B) HRs and p values of Cox regression analysis in non-serous histologic subtype using age as a dichotomous cutoff.
HRs, hazard ratios.
Fig. 3
Fig. 3. Age-specific OS analysis with patients aged <66 years or ≥66 years following propensity score matching.
OS, overall survival.
See this image and copyright information in PMC

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