Methods: Patients were recruited from a teaching hospital in northern Taiwan. A cohort study was performed on patients with ovarian cancer at the bedside for those undergoing surgery or at the outpatient settings for those completing active treatment. Medical records (disease status, clinical and demographic characteristics), self-reported patients' daily activities, sleep, and quality of life by EORTC QLQ-C30 and OV28 were collected. Moreover, we used global health in EORTC QLQ-C30 as a dependent variable for multivariate analysis, and correlated with age by fitting multiple linear regression models and using the stepwise variable selection procedure to identify the predictor.
Results: There was a total of 258 patients, where fifty-eight (22.66%) patients were in the elderly group (age≧60 years). Compared to the younger ovarian cancer patients, the elderly patients had more late stage (stages III and IV according to FIGO) ovarian cancer, and had a higher number of pregnancies and births. We found that BMI (at the time of diagnosis), chemotherapy protocol, the time since their primary chemotherapy, and recurrence rate upon completion of all treatment were not predictors. Fatigue, appetite/GI side effect, and education level (education below elementary) were negative predictors for QoL. The drug of chemotherapy only negatively impacted on QoL when interacting with age. The women self-reported good sleep quality and more years of survival after surgery were positive predictors for QoL.
Conclusion: The risk factor for the elderly group's lowered quality of life were being treated with Lipodox and less educational years. Therefore, we suggest providing the patient more individualized nursing intervention for managing side-effect symptom (fatigue and appetite/ GI problems), and providing nursing instruction for daily life to increase self-care ability and sleep quality during treatment and progression-free follow-up period in order to maintain their QOL.