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Gynecologic cancer in the very elderly
A W Kennedy1, J S Flagg, K D Webster
1Department of Gynecology, Cleveland Clinic Foundation, Ohio 44106.
Gynecologic Oncology
|January 1, 1989
Summary
Elderly women over 75 with gynecologic cancer often present with advanced stages and comorbidities. Despite this, they can typically receive definitive treatments, including surgery, with careful medical management.
Area of Science:
- Oncology
- Geriatrics
Background:
- Increasing elderly population in the US necessitates specific care strategies.
- Gynecologic cancer treatment in women over 75 requires tailored approaches.
Purpose of the Study:
- To review the Cleveland Clinic Foundation's experience treating gynecologic cancer in women aged 75+.
- To analyze cancer presentation, treatment morbidity/mortality, and survival in this demographic.
Main Methods:
- Retrospective chart review of 114 patients aged 75 years and older.
- Analysis of primary cancer presentation, treatment outcomes, and survival rates.
- Comparison with broader patient data for stage at diagnosis.
Main Results:
- Common comorbidities included cardiovascular disease and diabetes mellitus.
- Higher-than-expected advanced stages for endometrial, cervical, and vulvar cancers.
- 42 patients required therapy modification; no postoperative mortality, but prolonged hospitalizations occurred.
- Projected 5-year overall survival rate was 44%.
Conclusions:
- Very elderly patients with gynecologic cancer can often undergo definitive therapies, including surgery.
- Careful preoperative medical evaluation and management are crucial for successful treatment.
- Advanced age and comorbidities do not preclude effective cancer treatment in this population.