Feasibility and Safety of Extensive Upper Abdominal Surgery in Elderly Patients with Advanced Epithelial Ovarian Cancer

Abstract

We performed a retrospective study to evaluate the feasibility and safety of extensive upper abdominal surgery (EUAS) in elderly (≥65 yr) patients with advanced ovarian cancer. Records of patients with advanced epithelial ovarian cancer who received surgery at our institution between January 2001 and June 2005 were reviewed. A total of 137 patients including 32 (20.9%) elderly patients were identified. Co-morbidities were present in 37.5% of the elderly patients. Optimal cytoreduction was feasible in 87.5% of the elderly while 95.2% of young patients were optimally debulked (P=0.237). Among 77 patients who received one or more EUAS procedures, 16 (20.8%) were elderly. Within the cohort, the complication profile was not significantly different between the young and the elderly, except for pleural effusion and pneumothorax (P=0.028). Elderly patients who received 2 or more EUAS procedures, when compared to those 1 or less EUAS procedure, had significantly longer operation times (P=0.009), greater blood loss (P=0.002) and more intraoperative transfusions (P=0.030). EUAS procedures are feasible in elderly patients with good general condition. However, cautious peri-operative care should be given to this group because of their vulnerability to pulmonary complications and multiple EUAS procedures.

Clinicopathological Features and Surgical Safety of Gastric Cancer in Elderly Patients

“…Therefore radical surgery is thought to be applied to gastric cancer in elderly patients without significant risk of complications. This finding is similar to the result of a previous study about ovarian cancer, which revealed that extensive upper abdominal surgery is feasible in elderly patients ( 9 ). However considering that elderly patients have more risk of disease-related complications and larger rate of comorbidities, the decision for whether to do surgery for those with serious comorbidities should be considerate.…”

The Application and Outcome of Standard of Care Treatment in Elderly Women with Ovarian Cancer: A Literature Review over the Last 10 Years

“…This study found that the elderly group did not receive benefit from the interval cytoreduction with HIPEC treatment and instead experienced postoperative morbidity, with the most common being grade 4 hemoperitoneum and grade 3 intra-abdominal fluid collection in 22.2% of women ( 17 ). Another study that evaluated the feasibility and safety of extensive upper abdominal surgery (EUAS) in elderly patients with advanced ovarian cancer found no significant difference to that of younger patients, and concluded that EUAS procedures are feasible in this elderly population ( 35 ).…”

Management of the Elderly Patient With Gynecologic Cancer: Report of the 2011 Workshop in Geriatric Gynecologic Oncology

“…32,37,46Y49 Regarding postoperative morbidity, study results were inconsistent. 35,37 Elderly patients with ovarian cancer were less often treated by optimal surgery, and this was associated with decreased survival in large population-based studies. 34,36,38,43 However, age was also a significant survival factor after adjusting for other significant survival factors.…”