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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Annual Report on the Aging Society (2018) Cabinet office
National Comprehensive Cancer Network (2016) “NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Senior Adult Oncology”. [Version 2.2016]. https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf
Bachmann S, Finger C, Huss A et al (2010) Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ 340:c1718
Ellis G, Langhorne P (2004) Comprehensive geriatric assessment for older hospital patients. Br Med Bull 71:45–59
Ellis G, Gardner M, Tsiachristas A et al (2017) Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database Syst Rev 9:Cd006211
Stuck AE, Siu AL, Wieland GD et al (1993) Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 342(8878):1032–1036
Van Craen K, Braes T, Wellens N et al (2010) The effectiveness of inpatient geriatric evaluation and management units: a systematic review and meta-analysis. J Am Geriatr So. 58(1):83–92
Tinquaut F, Freyer G, Chauvin F et al (2016) Prognostic factors for overall survival in elderly patients with advanced ovarian cancer treated with chemotherapy: results of a pooled analysis of three GINECO phase II trials. Gynecol Oncol 143(1):22–26
Suh DH, Kim JW, Kim HS et al (2014) Pre- and intra-operative variables associated with surgical complications in elderly patients with gynecologic cancer: the clinical value of comprehensive geriatric assessment. J Geriatr Oncol 5(3):315–322
Toba K (2005) The guideline for comprehensive geriatric assessment. Jpn. J. Geriatr. 42:177–180
Acknowledgements
We thank the Japanese Gynecologic Oncology Group (JGOG-9003 s) participating sites for this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
No author has any conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Yamamoto, M., Yoshida, Y., Itani, Y. et al. How do doctors choose treatment for older gynecological cancer patients? A Japanese Gynecologic Oncology Group survey of gynecologic oncologists. Int J Clin Oncol 25, 741–745 (2020). https://doi.org/10.1007/s10147-019-01574-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10147-019-01574-z