Improving outcomes for older women with gynaecological malignancies.
Abstract
The incidence of most gynaecological malignancies rises significantly with increasing age. With an ageing population, the proportion of women over the age of 65 with cancer is expected to rise substantially over the next decade. Unfortunately, survival outcomes are much poorer in older patients and evidence suggests that older women with gynaecological cancers are less likely to receive current standard of care treatment options. Despite this, older women are under-represented in practice changing clinical studies. The evidence for efficacy and tolerability is therefore extrapolated from a younger; often more fit population and applied to in every day clinical practice to older patients with co-morbidities. There has been significant progress in the development of geriatric assessment in oncology to predict treatment outcomes and tolerability however there is still no clear evidence that undertaking a geriatric assessment improves patient outcomes. Clinical trials focusing on treating older patients are urgently required. In this review, we discuss the evidence for treatment of gynaecological cancers as well as methods of assessing older patients for therapy. Potential biomarkers of ageing are also summarised.
Collections
Subject
Humans
Ovarian Neoplasms
Endometrial Neoplasms
Antineoplastic Combined Chemotherapy Protocols
Treatment Outcome
Chemotherapy, Adjuvant
Radiotherapy, Adjuvant
Brachytherapy
Ovariectomy
Lymph Node Excision
Hysterectomy
Geriatric Assessment
Survival Rate
Age Factors
Aged
Aged, 80 and over
Frail Elderly
Disease Management
Uterine Cervical Neoplasms
Female
Language
eng
Date accepted
2016-08-20
License start date
2016-11
Citation
Cancer treatment reviews, 2016, 50 pp. 99 - 108