TY - JOUR T1 - Experience in the Management of Patients Older Than 80 Years With Vulval Cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 752-755 LP - 752-755 DO - 10.1111/IGC.0b013e31819d7d31 VL - 19 IS - 4 AU - Ahmed Talaat AU - Dirk Brinkmann AU - Yoodhvir Nagar AU - Patrick Hogston AU - Ghassan Khoury AU - Robert Woolas Y1 - 2009/04/01 UR - http://ijgc.bmj.com/content/19/4/752-755.abstract N2 - Introduction: Vulval cancer is a disease of an increasing elderly population and consequently comorbidities are common. These conditions may preclude the application of standard therapy.Objective: To review the outcome of women with vulval cancer older than 80 years comparing those who received recommended treatment (protocol-adherent) with those who did not (protocol-violated).Methods: A retrospective chart review of a consecutive series of patients discussed over a 6-year period at our Multidisciplinary Team meeting. Treatment was deemed protocol-adherent if the Royal College of Obstetricians and Gynaecologists guidelines were followed and protocol-violated if not. Outcome data were retrieved from case notes, primary care input, cancer registry database, and reviewed in terms of survival and recurrence.Results: Twenty-three cases of squamous cell carcinoma of the vulva were identified between 1999 and 2005 at Portsmouth Oncology Centre. Eight women were protocol-adherent and 15 women were not. Treatment decisions were made after individual discussion in conjunction with performance status. Protocol adherence was associated with a 25% recurrence rate and violation with a 53% recurrence rate. Median survival was shorter in the protocol-violated group compared with the adherent group (18 months vs 43.5 months respectively).Conclusion: These data imply that this issue arises not infrequently, perhaps every 3 to 4 months at each gynecological oncology Multidisciplinary Team meeting in the UK. The higher recurrence rate and shorter median survival among the protocol-violated group supports the validity of the current Royal College of Obstetricians and Gynaecologists treatment guidelines in this elderly age group. A prospective scoring system should be evolved to ensure a more objective approach to such patients with considerable co-morbidities. ER -