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[Correspondence] Primary chemotherapy versus primary surgery for ovarian cancer

We read with great interest the Article by Sean Kehoe and colleagues,1 in which they compare primary chemotherapy with primary surgery for patients with ovarian cancer. We agree that the median overall survival recorded in this trial is unexpectedly low. However, we disagree with the authors’ hypothesis that the slightly higher median age of the study population accounts for this low overall survival. Biological, rather than chronological, age predicts tolerance to stress. In geriatric oncology, patients who are not physically weak or frail and receive standard therapy have similar oncological outcomes compared with younger patients and live longer compared to those receiving less aggressive treatment because of their chronological age.