[Home hospice care for the patients with gynecological malignancies]

In order to clarify the clinical characteristics along with the practical care of home hospice care for gynecological cancer patients, we analyzed 37 terminally-ill gynecological cancer patients who died at home from July 1, 2003 through June 30, 2010, and these patients were compared with 762 non-gynecology cancer patients. The range of patients' ages with gynecological malignancies was statistically younger(p<0. 05)than that of the control patients, whereas the duration of home care and home death ratio did not show significant differences. As for medical treatment, the frequency of the management of nephrostomy was significantly higher in cases with gynecological malignancies. However, the frequencies of the usage of strong opioids, home oxygen therapy, home parenteral hyperalimentation, management of central venous port and indwelling bladder catheter showed no significant differences. There were patients, who needed special treatments by a gynecologist, with vesicovaginorectal fistula in one case, subcutaneous abscess probably caused by rectocutaneous fistula in one case, vaginal bleeding in one case and acute urinary retention treated by an emergent bladder puncture. By analyzing the focus problem lists of the total suffering at each clinical phase, in patients living longer than 15 days at home,(Kawagoe's classification in 1991)this did not show significant difference against the control group. In conclusion, gynecologic cancer patients were significantly younger than those with non-gynecologic malignancies, though not statistically significant, showing the tendency of short duration. Thus, in cases of gynecologic malignancies, it is important to take these characteristics into consideration.