Objective: To evaluate the feasibility and morbidity rate of primaryradical surgery in elderly patients with endometrial cancer and tocompare the findings with those of a cohort of younger women.Methods: Consecutive patients who underwent radical abdominalhysterectomy, bilateral adnexectomysystematic lymphadenectomyand peritoneal washing for endometrial cancer were includedin the study. The study population was divided in two groupsaccording to patients age: Group 175 years (n¼54) and Group270 years (n¼108). Coexisting medical disorders were evaluated:obesity, hypertension, diabetes, cardiopathies, chronic obstructivelung disease and peripheral vascular disease. The Mann-Whitney Utest and the Fisher exact test were used for statistical analysis.Results: The median patients age was 77.5 years (75—89) and 52.5 years (39—70) in Group 1 and Group 2, respectively. The incidence of intercurrent medical conditions (90.7% vs. 44.4%) and the proportion of patients with high anaesthesiologic risk (ASA 3—4) (79.6% vs. 26.8%) were higher in group 1 than in group2 (P<0.0001). No significant difference was observed in the incidence of diabetes and obesity between groups. Systematic lymphadenectomy was performed in 23 elderly and in 46 younger patients (42.6% vs. 42.6%, P¼1.0). No difference was found in intraoperative charcharacteristics and postoperative complications of the two groups, according to the performance or not of the lymphadenectomy.Conclusion: Chronological age alone is an insufficient determinantof surgical risk. Thank to optimized clinical and surgical management, elderly patients tolerate radical surgery almost as well as their younger counterparts.
Primary radical surgery for endometrial cancer in elderly patients.
BERGAMINI, VALENTINO;FRANCHI, Massimo Piergiuseppe
2004-01-01
Abstract
Objective: To evaluate the feasibility and morbidity rate of primaryradical surgery in elderly patients with endometrial cancer and tocompare the findings with those of a cohort of younger women.Methods: Consecutive patients who underwent radical abdominalhysterectomy, bilateral adnexectomysystematic lymphadenectomyand peritoneal washing for endometrial cancer were includedin the study. The study population was divided in two groupsaccording to patients age: Group 175 years (n¼54) and Group270 years (n¼108). Coexisting medical disorders were evaluated:obesity, hypertension, diabetes, cardiopathies, chronic obstructivelung disease and peripheral vascular disease. The Mann-Whitney Utest and the Fisher exact test were used for statistical analysis.Results: The median patients age was 77.5 years (75—89) and 52.5 years (39—70) in Group 1 and Group 2, respectively. The incidence of intercurrent medical conditions (90.7% vs. 44.4%) and the proportion of patients with high anaesthesiologic risk (ASA 3—4) (79.6% vs. 26.8%) were higher in group 1 than in group2 (P<0.0001). No significant difference was observed in the incidence of diabetes and obesity between groups. Systematic lymphadenectomy was performed in 23 elderly and in 46 younger patients (42.6% vs. 42.6%, P¼1.0). No difference was found in intraoperative charcharacteristics and postoperative complications of the two groups, according to the performance or not of the lymphadenectomy.Conclusion: Chronological age alone is an insufficient determinantof surgical risk. Thank to optimized clinical and surgical management, elderly patients tolerate radical surgery almost as well as their younger counterparts.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
