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Sep 12, 2019

The Annual Global Meeting of the International Gynecologic Cancer Society

WHO ARE YOU CALLING OLD? PRACTICE PATTERNS AND MANAGEMENT OF NONAGENARIANS PRESENTING TO A GYNECOLOGIC ONCOLOGIST FOR INITIAL CONSULTATION

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gynecologic oncology

frailty index

elderly

cancer treatment

nonagenarian

geriatric cancer care

geriatric oncology

endometrial cancer

ovarian cancer

Abstract

Abstract

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Keywords

gynecologic oncology

frailty index

elderly

cancer treatment

nonagenarian

geriatric cancer care

geriatric oncology

endometrial cancer

ovarian cancer

Abstract

Objectives: To describe the practice patterns and treatment for nonagenarians who initiated care with a gynecologic oncologist. Methods: Retrospective chart review of women aged 90 or older who presented to a gynecologic oncologist between 10/09 and 12/18 at an urban academic medical center. Descriptive statistics were used for variables of interest. Results: We identified 34 nonagenarians (median age 92, range 90-98): 10 (29%) had benign disease, 8 (24%) pre-malignancy or suspected malignancy, and 16 (47%) malignancy. The initial care plan commented on age and functional status for 79% of women. Of the 8 with suspected malignancy, 5 declined further workup. The cancer distribution revealed 5 (31%) vulvar, 5 (31%) uterine, 4 (25%) ovarian, 1 (6%) vaginal and 1 (6%) cervical cancers. Combined, 37% had stage I disease; 6% stage 3; 6% stage 4; 13% recurrent; and 25% unstaged. Excluding one patient lost to follow-up, all 15 patients received treatment plans: 7 (47%) with palliative intent and 8 (53%) with curative intent. In the curative group, 7 underwent surgery (1 with adjuvant chemotherapy) and 1 chemoradiation. In the palliative group, 4 underwent radiation, 1 chemotherapy and 2 declined/unknown. Overall, 13 (87%) completed the proposed treatment. Treatment-related complications included 1 superficial skin infection and 1 thirty-day readmission for an unrelated traumatic injury. Conclusions: Nonagenarians most commonly presented with vulvar or endometrial cancer and 87% successfully completed treatment with minimal adverse effects or toxicity. Age and functional status were discussed in the care plan for 79% of women, but did not preclude treatments that had the potential to preserve meaningful quality of life and/or cure patients of their disease.

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© Copyright 2019 Morressier GmbH.
All rights reserved.