Management of the Elderly Patient With Gynecologic Cancer

Suh, Dong Hoon; Kang, Sokbom; Lim, Myong Cheol; Lee, Taek Sang; Kim, Tae Joong; Kim, Jee Hyun; Lee, Kwang Beom; Park, Dong Choon; Chung, Hyun Hoon; Kim, Kidong; Seo, Sang Soo; Kim, Hak Jae; Kim, Mi Kyung; Ju, Woong; Kim, Jae Weon; Lichtman, Stuart M.; Park, Soo‐Jin

doi:10.1097/igc.0b013e318234f8d5

Cited by 12 publications

(5 citation statements)

References 88 publications

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“…In the future, there will be more tailored and individualized strategies in the oncologic care of elderly patients which will reflect their functional age [19,20]. With current standards of anesthesia and postoperative surveillance, it is possible for many elderly women to safely undergo OC surgery, and only a minority of the patients must strictly be categorized as "inoperable" or "unfit for surgery".…”

Section: B) the Incidental Findingsmentioning

confidence: 98%

Epidemiology in ovarian carcinoma: Lessons from autopsy

Güth

Arndt

Stadlmann

et al. 2015

Gynecologic Oncology

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OBJECTIVE We challenge epidemiologic knowledge regarding ovarian carcinoma (OC) by bridging the gap between clinical and autopsy data. METHODS Autopsy reports, histological slides and clinical files from 660 patients in whom OC was diagnosed from 1975-2005 were studied (autopsy cohort, n=233; Clinical Cancer Registry from the local gyneco-oncologic center, n=427). RESULTS Out of the autopsy cohort, we identified four distinct subgroups of patients: 1) OC was diagnosed before autopsy, n=156 (67.0%). 2) OC was an incidental finding, n=16 (6.8%).3) The ovarian tumors were not primary OC but rather metastases from other primary tumors; this revised diagnosis was first made by using current histopathological knowledge/techniques, n=24 (10.3%). 4) Death was directly due to OC in its final stage and OC was first diagnosed by autopsy, n=37 (15.9%); when these cases were added to the Clinical Cancer Registry to an adjusted OC incidence model, the autopsy cases comprised 8.8% of the adjusted cohort and almost doubled the percentage of oldest patients ( 80 years at diagnosis) from 4.9% to 9.3% (p=0.013). CONCLUSIONS Epidemiological data from the 1970s-1990s may overestimate true incidence because up to 10% of carcinomas in the ovary were not properly classified. Patients who were first diagnosed with OC by autopsy comprise a distinct subgroup. These are patients who have not been seen by specialized oncologists and thus play no role in their perception of the disease. Nevertheless, these cases have impact on prevalence and incidence data of OC and in an era of reduced autopsy rates will probably be overlooked. Nevertheless, these cases have impact on prevalence and incidence data of OC and in an era of 54 reduced autopsy rates will probably be overlooked.

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Section: B) the Incidental Findingsmentioning

confidence: 98%

Epidemiology in ovarian carcinoma: Lessons from autopsy

Güth

Arndt

Stadlmann

et al. 2015

Gynecologic Oncology

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“…Population-based data estimate that between 2003 and 2007, 54% of all new cancer cases and 70% of cancer-related deaths occurred in patients 65 years of age or older [62]. Cervical cancer demonstrates a bimodal distribution, with peaks between 30 and 39 years of age and between 60 and 69 years of age.…”

Section: Cervical Cancer In Older Womenmentioning

confidence: 99%

The surgical management of early-stage cervical cancer

Salicrú

Torre

2013

Current Opinion in Obstetrics &Amp; Gynecology

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There is a growing trend to practice less aggressive surgery in order to preserve fertility in young women and avoid an excess of treatment in some selected patients. Therefore, nerve-sparing techniques can help to improve the quality of life. More studies are needed to demonstrate oncologic results of the sentinel node technique. Laparoscopic and robotic-assisted surgery can substitute open surgical treatment.

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“…Previous studies have evaluated the safety and feasibility of laparoscopy in gynecological surgery for older patients [13][14][15]. However, the definition of "older patients" is arbitrary and varies between studies.…”

Section: Introductionmentioning

confidence: 99%

Advantages of laparoscopy in gynecologic surgery in elderly patients

Na,

Chung,

Jang

et al. 2024

Obstet Gynecol Sci

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Objective Geriatric patients requiring gynecological surgery is increasing worldwide. However, older patients are at higher risk of postoperative morbidity and mortality, particularly cardiopulmonary complications. Laparoscopic surgery is widely used as a minimally invasive method for reducing postoperative morbidities. We compared the outcomes of open and laparoscopic gynecologic surgeries in patients older than 55 years.Methods We included patients aged >55 years who underwent gynecological surgery at a single tertiary center between 2010 and 2020, excluding vaginal or ovarian cancer surgeries were excluded. Surgical outcomes were compared between the open surgery and laparoscopic groups, with age cutoff was set at 65 years for optimal discriminative power. We performed linear or logistic regression analyses to compare the surgical outcomes according to age and operation type.Results Among 2,983 patients, 28.6% underwent open surgery and 71.4% underwent laparoscopic surgery. Perioperative outcomes of laparoscopic surgery were better than those of open surgery in all groups. In both the open and laparoscopic surgery groups, the older patients showed worse overall surgical outcomes. However, age-related differences in perioperative outcomes were less severe in the laparoscopic group. In the linear regression analysis, the differences in estimated blood loss, transfusion, and hospital stay between the age groups were smaller in the laparoscopy group. Similar results were observed in cancer-only and benign-only cohorts.Conclusion Although the surgical outcomes were worse in the older patients, the difference between age groups was smaller for laparoscopic surgery. Laparoscopic surgery offers more advantages and safety in patients aged >65 years.

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Management of the Elderly Patient With Gynecologic Cancer

Cited by 12 publications

References 88 publications

Epidemiology in ovarian carcinoma: Lessons from autopsy

Epidemiology in ovarian carcinoma: Lessons from autopsy

The surgical management of early-stage cervical cancer

Advantages of laparoscopy in gynecologic surgery in elderly patients

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