J Korean Med Sci.  2010 Jul;25(7):1034-1040. 10.3346/jkms.2010.25.7.1034.

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

• Lim MC
• Kang S
• Song YJ
• Park SH
• Park SY

• KMID: 1792953
• DOI: http://doi.org/10.3346/jkms.2010.25.7.1034

Abstract

We performed a retrospective study to evaluate the feasibility and safety of extensive upper abdominal surgery (EUAS) in elderly (> or =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.

Keyword

Ovarian Neoplasms; Surgery; Aged; Extensive Upper Abdominal Surgery; Complications; Risk Factors

MeSH Terms

Abdomen/*surgery
Adult
Age Factors
Aged
Disease-Free Survival
Female
*Gynecologic Surgical Procedures/adverse effects
Humans
Kaplan-Meiers Estimate
Middle Aged
Ovarian Neoplasms/mortality/*pathology/*surgery
Retrospective Studies
Treatment Outcome

Figure

• 

  Fig. 1 Kaplan-Meier survival analysis of the young and the elderly patients with advanced ovarian cancer. (A) Progression free survival distribution by age (P=0.190, by log-rank test). (B) Overall survival distribution by age (P=0.016, by log-rank test).

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