Journal
GYNECOLOGIC ONCOLOGY
Volume 157, Issue 3, Pages 593-598Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2020.03.005
Keywords
Ovarian cancer; Treatment patterns; Guideline adherence; Reasons; Older patients
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Funding
- Aart Huisman Scholarschip for research in geriatric oncology
- Cornelis Visser Foundation
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Objective. This study aims to assess the reasons for guideline non-adherence in women with advanced stage ovarian cancer and whether these reasons differ according to age. Methods. All women diagnosed with advanced stage ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) IIb-IV, between 2015 and 2018 were selected from the Netherlands Cancer Registry. Treatment patterns and reasons for guideline non-adherence were analyzed according to age groups. Results. 4210 women were included, of whom 34%, 33%, 26%, and 8% were aged <65, 65-75, 75-85, and >= 85 years respectively. With advancing age, less women received guideline-adherent treatment (decreasing from 70% to 2% in women aged <65 and >= 85 years respectively) and more women received best supportive care only (ranging from 4% to 69% in women aged <65 and >= 85 years respectively). The most prevalent reasons for guideline non-adherence differed according to age and included patient preference in olderwomen, and functional status and extent of disease in younger women. Conclusions. Most olderwomen did not receive guideline-adherent care and patient preferencewas themost common reason for this decision. This knowledge provides insight in the current treatment decision-making process and highlights the importance of eliciting patient treatment preferences. Further prospective research is necessary to study the underlying motivation for women to decline guideline care and the extent to which shared decision-making influences treatment choice. (C) 2020 Elsevier Inc. All rights reserved.
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