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How do doctors choose treatment for older gynecological cancer patients? A Japanese Gynecologic Oncology Group survey of gynecologic oncologists

  • Makoto Yamamoto
  • Yoshio YoshidaEmail author
  • Yoshio Itani
  • Shinya Sato
  • Masayuki Futagami
  • Hitomi Sakai
  • Hiroaki Kajiyama
  • Masaki Fujimura
  • Yoichi Aoki
Original Article

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.

Keywords

Elderly Geriatrics Gynecologic cancer Comprehensive geriatric assessment 

Notes

Acknowledgements

We thank the Japanese Gynecologic Oncology Group (JGOG-9003 s) participating sites for this study.

Compliance with ethical standards

Conflict of interest

No author has any conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Faculty of Medical SciencesUniversity of FukuiFukuiJapan
  2. 2.Department of Obstetrics and GynecologyNara Prefecture Seiwa Medical CenterNaraJapan
  3. 3.Department of Obstetrics and GynecologyTottori University School of MedicineTottoriJapan
  4. 4.Department of Obstetrics and GynecologyHirosaki University Graduate School of MedicineAomoriJapan
  5. 5.Department of Medical Oncology, Faculty of MedicineKindai UniversityOsakaJapan
  6. 6.Department of Obstetrics and GynecologyNagoya University Graduate School of MedicineNagoyaJapan
  7. 7.Department of Obstetrics and GynecologyTokyo Medical University Ibaraki Medical CenterIbarakiJapan
  8. 8.Department of Obstetrics and Gynecology, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan

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