(PM P21) Outcomes in Elderly Ovarian Cancer Patients Treated with CytoreductiveSurgery plus Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC)

Introduction: No consensus has been reached concerning the best treatment for epithelial ovarian cancer (EOC) in patients ≥65.We present our outcomes of elderly patients treated with CRS/HIPEC.

Methods: A prospective database of EOC patients treated with CRS/HIPEC between 1999-2018 was reviewed and peri-operative variables were compared by treatment: 1) upfront CRS/HIPEC, 2) salvage CRS/HIPEC, 3) neoadjuvant chemotherapy+CRS/HIPEC (neo-HIPEC), and age at surgery: ≥65 and <65. Kaplan-Meier method was used for survival analysis.

Results: Of 148 women with advanced EOC, 45 had upfront CRS/HIPEC, 61 salvage CRS/HIPEC and, 42 neo-HIPEC (p=0.012). Survival by age showed 1, 3, 5-year OS for upfront HIPEC was 79, 59 and 59% (≥65 group) vs 100, 88 and 70% (<65 group). The 1, 3, 5-year OS for salvage HIPEC was 77, 48, and 48% (≥65 group) vs 86, 58, and 53% (<65). The 1, 3, 5-year OS for neo-HIPEC was 83, 46 and 46% (≥65 group) vs 92, 50 and 25% (<65). PFS at 1, 3, 5-years in upfront HIPEC was 89, 76 and 46% (≥65 group) vs 93, 56 and 51% (<65). PFS at 1, 3, 5-years in salvage HIPEC was 49, 24, and 24% (≥65 group) vs 68, 40, and 34% (<65). PFS at 1, 3, 5-years in neo-HIPEC was 58, 24, and 12% (≥65 group) vs 40, 16, and 16% (<65).

Conclusion: Age is an important factor to consider when selecting treatment modalities in elderly patients. However, a carefully selected elderly population can significantly benefit from an aggressive treatment modality.