[Trends in XXXX treatment in the elderly at a @entity0 outpatient clinic: guidelines followed better].

@entity1 @entity0
OBJECTIVE: To investigate the treatment of resectable @entity0 in elderly @entity1 at Alkmaar Medical Centre, Alkmaar, the Netherlands, before and after the introduction of a multidisciplinary @entity0 consultation (MDC) with the @entity0 team in February 2006. DESIGN: Retrospective. METHOD: The treatment of @entity1 aged 70 and over with newly diagnosed stage I and II resectable @entity0 was monitored during the period 2002-2007. RESULTS: A total of 84% of the 232 studied @entity1 were treated surgically. Adjuvant treatment with radiotherapy, hormone therapy and chemotherapy was given to 88, 91 and 5 @entity1 , respectively. The percentage of @entity1 who underwent first-line surgery decreased significantly, mainly because fewer @entity1 aged 80 or over received surgery. The number of @entity1 given radiotherapy in accordance with guidelines increased, while for hormonal therapy the number remained more or less the same. Recording of decisions that involved deviation from treatment guidelines improved in the study period. CONCLUSION: In 2002-2007, the @entity0 team became more aware of treatment guidelines and deviations from guidelines were better accounted for. In the elderly, the guidelines for adjuvant radiotherapy were followed better, but there was a remarkable decrease in primary surgical treatment of @entity1 , particularly in @entity1 aged 80 and over. Comorbidity and @entity1 ' preferences played an important role in this.
