Makoto Yamamoto1, Yoshio Yoshida2, Yoshio Itani3, Shinya Sato4, Masayuki Futagami5, Hitomi Sakai6, Hiroaki Kajiyama7, Masaki Fujimura8, Yoichi Aoki9. 1. Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan. 2. Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan. yyoshida@u-fukui.ac.jp. 3. Department of Obstetrics and Gynecology, Nara Prefecture Seiwa Medical Center, Nara, Japan. 4. Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan. 5. Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Aomori, Japan. 6. Department of Medical Oncology, Faculty of Medicine, Kindai University, Osaka, Japan. 7. Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 8. Department of Obstetrics and Gynecology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan. 9. Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Abstract
BACKGROUND: The proportion of elderly Japanese people (age ≥ 65 years) is currently 27.7%, and the average life span of women is 87.14 years, both of which are unprecedented. In gynecologic cancer, evidence of treatment for the elderly is scarce, and treatment policies are determined by each facility. The aim of the present study was to investigate the status of treatment policies for elderly patients with gynecologic cancer. METHODS: A web-based questionnaire regarding how treatment strategies are currently determined for elderly patients with gynecologic cancer was conducted on gynecologic oncologists to develop a tool for the objective evaluation of treatment policy decisions for elderly patients. RESULTS: The responses showed that 48% of the gynecologic oncologists were aware of comprehensive geriatric assessment (CGA), but only 6% had actually conducted CGA. Age, comorbidities, performance status, and pretreatment evaluations were regarded as important in determining the treatment strategy. Invasive treatments such as radical hysterectomy and para-aortic lymph node dissection tended to have age limits. CONCLUSIONS: These findings suggest that awareness of CGA is low in Japan, and that elderly people may not be given standard therapy, which highlights the importance of building on these findings by gathering further evidence and developing a new tool for predicting treatment outcomes for elderly patients with gynecologic cancer.
BACKGROUND: The proportion of elderly Japanese people (age ≥ 65 years) is currently 27.7%, and the average life span of women is 87.14 years, both of which are unprecedented. In gynecologic cancer, evidence of treatment for the elderly is scarce, and treatment policies are determined by each facility. The aim of the present study was to investigate the status of treatment policies for elderly patients with gynecologic cancer. METHODS: A web-based questionnaire regarding how treatment strategies are currently determined for elderly patients with gynecologic cancer was conducted on gynecologic oncologists to develop a tool for the objective evaluation of treatment policy decisions for elderly patients. RESULTS: The responses showed that 48% of the gynecologic oncologists were aware of comprehensive geriatric assessment (CGA), but only 6% had actually conducted CGA. Age, comorbidities, performance status, and pretreatment evaluations were regarded as important in determining the treatment strategy. Invasive treatments such as radical hysterectomy and para-aortic lymph node dissection tended to have age limits. CONCLUSIONS: These findings suggest that awareness of CGA is low in Japan, and that elderly people may not be given standard therapy, which highlights the importance of building on these findings by gathering further evidence and developing a new tool for predicting treatment outcomes for elderly patients with gynecologic cancer.
Entities:
Keywords:
Comprehensive geriatric assessment; Elderly; Geriatrics; Gynecologic cancer
Authors: Katleen Van Craen; Tom Braes; Nathalie Wellens; Kris Denhaerynck; Johan Flamaing; Philip Moons; Steven Boonen; Christiane Gosset; Jean Petermans; Koen Milisen Journal: J Am Geriatr Soc Date: 2009-12-09 Impact factor: 5.562