Aging affects regrowth of stealth peritoneal dissemination of advanced ovarian cancer: A multicenter retrospective cohort study

Abstract Aging contributes to a worse prognosis in advanced ovarian cancer patients with peritoneal dissemination that was completely resected in the debulking surgery. Ovarian cancer (OvCa) is one of the most lethal gynecological malignancies, and most patients are diagnosed at advanced stage with peritoneal dissemination. Although age at diagnosis is considered an independent prognostic factor, its impact on peritoneal recurrence after combined cytoreductive surgery and chemotherapy is not clear. The objective of this study was to investigate the impact of aging on peritoneal recurrence from stealth dissemination and gain insight of the pathophysiology of OvCa in elderly patients. A total of 243 patients with pT2b-pT3 epithelial ovarian who achieved complete surgery, no-residual tumor at first surgery, were selected to be analyzed the risk of peritoneal seeding and recurrence. We found that age over 65 years was independently associated with an increased risk of peritoneum-specific (PS) recurrence Furthermore, pT3 stages and positive ascites cytology also worsen the PS-recurrence-free survival. Collectively, our findings suggest that age, especially over 65 years, predicts reduced peritoneum-specific tumor recurrence in patients with advanced OvCa after complete cytoreduction surgery, particularly those with pT3 tumors and positive ascites cytology.