In recent years, major advances have been made toward the individualization of epithelial ovarian cancer care, leading to an overall improvement of patient outcomes. However, real-life data indicate that the oldest populations do not benefit from this, due to aspects related to cancer (more aggressive histopathological features), treatment (i.e. frequently suboptimal), and the host (increased toxicities in patients with lower physiological reserve). A specific risk-benefit perspective should therefore be taken when considering surgery, chemotherapy, and maintenance treatments: the decision for cytoreductive surgery should include geriatric vulnerability and surgical complexity, neo-adjuvant chemotherapy being an option when primary surgery appears at high risk; carboplatin paclitaxel association remains the standard even in vulnerable older patients; and bevacizumab and poly(ADP-ribose) polymerase inhibitors maintenance are interesting options provided they are prescribed according to their indications with a close monitoring of their toxicities. Future studies should aim to individualize care without limiting access of older patients to innovation. A specific focus is needed on age-specific translational analyses (focusing on tumor mutational burden and impaired biological pathways), a better patient stratification according to geriatric parameters, an adaptation of both oncological treatment and geriatric interventions, and treatment adaptations not a priori but according to formal pharmacokinetic data.

中文翻译：

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老年患者的卵巢癌：我们现在在哪里？接下来做什么？

近年来，上皮性卵巢癌护理的个体化取得了重大进展，导致患者预后的整体改善。然而，现实生活中的数据表明，由于与癌症（更具侵袭性的组织病理学特征）、治疗（即经常次优）和宿主（生理储备较低的患者的毒性增加）相关的方面，最古老的人群并没有从中受益。 。因此，在考虑手术、化疗和维持治疗时，应采取特定的风险效益观点：细胞减灭术的决定应考虑老年人的脆弱性和手术的复杂性，当初次手术出现高风险时，新辅助化疗是一种选择；即使在脆弱的老年患者中，卡铂紫杉醇联合仍然是标准；贝伐珠单抗和聚（ADP-核糖）聚合酶抑制剂的维持治疗是有趣的选择，前提是根据其适应症开处方并密切监测其毒性。未来的研究应致力于个体化护理，同时不限制老年患者获得创新的机会。需要特别关注特定年龄的转化分析（关注肿瘤突变负荷和受损的生物途径）、根据老年参数更好的患者分层、肿瘤治疗和老年干预的调整，以及治疗的调整不是先验的而是根据正式的药代动力学数据。