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Kazuo Tamura

General Medical Research Center, General Medical Research Center,

Fukuoka City, Japan

Japan is one of the countries where people aged over 65 is

rapidly increasing and they accounted for 26.7% of 126 million

populations in 2015 and the rate will be over 30% in 2025. We

are already in the aged society which leads to a large number

of elderly cancer patients. It has put a heavy burden on the

medical as well as Japanese society. To conquer such burden,

the Cancer Control Act was implemented in 2007, and one

regional cancer treatment hospital (RCTH) was established

in 400,000 populations (a total of 399 hospitals). RCTHs are

affiliated with a pivotal center for cancer in each prefecture

(49 centers) qualified by the Ministry of Health, Labour and

Welfare.The main purpose to establish such cancer treatment

system is to provide an equal access to the standard cancer

care by a multidisciplinary professional team throughout

Japan. In each RCTH, Cancer Board is held regularly by

physicians and other medical staff to discuss the complicated

patients especially for the elderly who often have multiple

comorbidities and functional derangement. The Cancer

Control Act has also reinforced education and training of

oncology in under- and post-graduate education curriculum.

Because of an overwhelming large number of the elderly

patients, RCTH alone cannot manage all patients from

diagnosis of cancer to the end of life. Therefore, RCTH needs

to collaborate with local hospitals and/or primary care

physicians who treat patients at home with nurses, care

workers and attendants. For example, in Shimane prefecture

located in the west-northern district of Japan, senior citizens

comprised 32.6% in 0.71 million populations in 2015. Shimane

University Hospital has made a ‘team oncology’ which has

established a management system for elderly lung cancer

patients. Geriatric assessments are undertaken by nurses or

pharmacists on a common assessment sheet in the electric

medical record (EMR). Patients’ information can be reviewed

among the University hospital and 31 local hospitals by

using the EMR through an internet and it is also accessible

to primary medical offices, pharmacies and nursing homes.

They have a trial of treating the cancer patients more closely

in collaboration with each other, and also will expand the

system to other malignancies.

The Japan Agency for Medical Research and Development

(AMED) was established in 2015 to promote and maintain an

environment for integrated research and development in the

field of medicine. To provide a one-stop service for research

expenses, AMED consolidated budgets from 3 Ministries

involving education, health and industry. Among many

research themes, management of the elderly with cancer is

one of the important subjects supported by AMED.

Thus, Japanese society is moving forward to cope with an

increasing number of elderly cancer patients by a team in

broad sense consisting of cancer professionals, other health

care providers and government, and by establishing a regional

medical network system further.

Disclosure of interest:

None declared




Memorial Sloan Kettering Cancer Center, Department of Medicine,

Gynecologic Medical Oncology Service, New York, USA

Ovarian cancer (OC) is the leading cause of mortality

among patients with gynecologic malignancies. More than

half of all OC occurs in women older than 65. Management of

newly diagnosed advanced ovarian cancer (OC) typically starts

with the combination of extensive debulking surgery and

postoperative platinum and paclitaxel chemotherapy. Careful

consideration of the chemotherapy dosing, scheduling, route,

and timing (neoadjuvant or postoperative) is essential. To

determine the safest andmost effective treatment, one should

consider a pretreatment geriatric assessment (GA) and close

cooperation with the gynecologic surgeon. In this session, we

will review the current guidelines and evidence of surgery and

chemotherapy in the older woman with ovarian cancer and

how to coordinate care within a multidisciplinary team.

Disclosure of interest:

None declared


Janice Tsang

The speaker abstract has not been received at the time of





Giampaolo Ugolini

University of Bologna, Department of Surgical and Medical

Sciences, Bologna, Italy

Elderly patients do not have a worse cancer survival than

younger patients; however, it is well known that they are at

higher risk of developing postoperative complications because

they are often affected by multiple comorbidities. It has been

reported that up to 80% of elderly patients might experience a

surgical complication that will more often lead to permanent

disability and postoperative mortality. The presentation will

focus on evidence-based perioperative strategies to improve

outcomes of onco-geriatric patients with a particular focus on

quality of life and functional recovery after surgery.

Disclosure of interest:

None declared