Systematic pelvic and aortic lymphadenectomy in elderly gynecologic oncologic patients

BACKGROUND. Retroperitoneal lymph node dissection is a fundamental step in the surgical management of patients with pelvic gynecologic malignancies bu t its, applicability to geriatric patients is controversial. The objective of this study was to evaluate whether pelvic and aortic lymphadenectomy in elderly patients with gynecologic malignancies can be a safe procedure in t erms of morbidity and mortality. METHODS. in a retrospective case-control study, the authors compared morbid ity, mortality, and surgical data in a series of elderly patients (age > 70 years) with endometrial and ovarian carcinoma who underwent surgery. Patie nts were divided into two groups: Cases were 36 elderly patients who underw ent surgery and pelvic and/or aortic lymphadenectomy and were matched with 72 controls who were, patients who underwent surgery without lymphadenectom y. RESULTS. Cases showed a significantly longer median operative time than con trols (median, 162 minutes [range, 85-330 minutes] vs. median, 100 minutes [range 20-310 minutes], respectively; P = 0.003). No significant difference between the two groups in terms of blood loss, blood transfusions, intraop erative complications, duration of ileus, reintervention required, or posto perative hospital stay were observed. One patient in the control group died . The type and frequency of severe postoperative complications in the two g roups were not substantially different. CONCLUSIONS. Pelvic and aortic lymphadenectomy was performed safely in elde rly patients age greater than or equal to 70 years with endometrial and ova rian carcinoma without an increase in morbidity and mortality. Advanced chr onologic age alone should not be considered a contraindication to full surg ical treatment in these patients. (C) 2001 American Cancer Society.