Management of Gynecological Cancer Patients Older than 70 Years of Age

SummaryBackgroundThe incidence of geriatric oncology patients has not been studied very well. A retrospective study of the incidence of geriatric patients with malignant gynecological disease is therefore presented.Patients and methodsFrom 1982 until 2006, a total of 8377 patients with gynecological malignancies were treated in our clinic, 834 (10%) of whom were aged ≥70 years. In the analysis, annual reports of the clinic were used and the personal histories of patients aged ≥70 years (834 patients) were analyzed. The statistical method used was Fisher's exact test.ResultsThe number of patients aged 70–74 years, 75–79 years, and ≥80 years were 528 (63.3%), 215 (25.8%), and 91 (10.9%), respectively. Endometrial cancer was detected in 240 cases (28.77%), ovarian cancer in 192 cases (23.02%), vulvar cancer in 180 cases (21.58%), cervical cancer in 169 cases (20.26%), uterine sarcoma in 37 cases (4.43%), and vaginal cancer in 16 cases (1.91%). The comorbidities included were hypertension, diabetes, cardiovascular disease, pulmonary disease, and cerebrovascular disease. Operation was performed in 655 cases (78%), radiation therapy only in 152 cases (18%), and chemotherapy only in 27 cases (3%). In the present study, the in-hospital complication rate occurred in 78 cases (9.3%). In the group of patients aged >80 years, the in-hospital complication rate occurred in 20 cases (21%). No case of death related to surgery occurred.ConclusionThe key in choosing the treatment therapy is the localization and the stage of the cancer, whereas patient age and different chronic diseases are relevant to the treatment strategies used. The cases of geriatric gynecological malignancies were treated following the same guidelines used for younger patients. An increase in elderly surgical cancer workload is inevitable in the coming years. The special needs of elderly cancer patients should be taken into consideration prior to treatment planning.