Endometrial cancer in elderly patients

Endometrial cancer (EC) has an important impact on the elderly population, being estimated that 40% of patients who receive its diagnosis are aged 65 or older, and 67% of related deaths occur in patients over 65. Moreover, EC is expected to increase in prevalence with an increasingly aged and obese population. A large number of explanations have been offered to explain the increased cancer-specific death rate of geriatric patients, including not only increased comorbidities and a relatively common under-treatment, but also a more advanced disease stage at diagnosis, a higher tumor grade, and a more aggressive tumor biology. Older patients with EC should be assessed for their fitness before receiving any type of surgical and medical treatment. The involvement of the patients’ primary care gynecologist and geriatrician helps to provide a better evaluation both of overall fitness and the care goals of geriatric patients. The aim of this chapter is to discuss the steps in the diagnosis of EC in the elderly, the approaches to its treatment, and the role of geriatric assessment in the management of these patients.