Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
Department of Obstetrics and Gynecology, Nara Prefecture Seiwa Medical Center, Nara, Japan.
Int J Clin Oncol. 2020 Apr;25(4):741-745. doi: 10.1007/s10147-019-01574-z. Epub 2019 Nov 14.
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.
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.
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.
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.
目前日本老年人（年龄≥65 岁）的比例为 27.7%，女性的平均寿命为 87.14 岁，均前所未有。在妇科癌症中，针对老年人的治疗证据很少，治疗政策由每个医疗机构决定。本研究旨在调查妇科癌症老年患者治疗政策的现状。
对妇科肿瘤学家进行了一项关于如何为妇科癌症老年患者制定治疗策略的网络问卷调查，以开发一种用于客观评估老年患者治疗决策的工具。
结果表明，48%的妇科肿瘤学家了解全面老年评估（CGA），但只有 6%的人实际进行了 CGA。年龄、合并症、体能状态和治疗前评估被认为是决定治疗策略的重要因素。根治性子宫切除术和腹主动脉旁淋巴结清扫等侵袭性治疗往往有年龄限制。
这些发现表明，日本对 CGA 的认识较低，老年人可能无法接受标准治疗，这凸显了通过收集更多证据和开发用于预测妇科癌症老年患者治疗结果的新工具来利用这些发现的重要性。
