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Pelvic exenteration in the elderly patient.
C M Matthews1, M Morris, T W Burke
1Department of Gynecology, University of Texas M.D. Anderson Cancer Center, Houston.
Obstetrics and Gynecology
|May 1, 1992
Summary
Radical exenterative surgery in older patients (age 65+) shows comparable survival and mortality rates to younger patients. While complications are common, many are infectious and not life-threatening, suggesting age alone isn't a contraindication.
Area of Science:
- Oncology
- Surgical Oncology
- Geriatric Surgery
Background:
- Advanced age is often considered a contraindication for radical exenterative surgery.
- Pelvic exenteration is a complex procedure with significant morbidity.
Purpose of the Study:
- To evaluate the outcomes of pelvic exenteration in elderly patients (age 65 and older).
- To compare the outcomes of pelvic exenteration in elderly patients versus younger patients.
Main Methods:
- Retrospective review of 63 patients aged 65+ who underwent pelvic exenteration (1960-1991).
- Analysis of complication rates, operative mortality, recurrence, and survival.
- Comparison with 363 younger patients undergoing the same procedure.
Main Results:
- 38% experienced major complications, 38% minor; 60% had infectious complications.
- Operative mortality was 11% in the older group vs. 8.5% in the younger group (not significant).
- 5-year survival was 46% in the older group vs. 45% in the younger group (not significant).
Conclusions:
- Pelvic exenteration can be performed in elderly patients with outcomes comparable to younger patients.
- Infectious morbidity is common but often manageable.
- Age alone should not be a contraindication for radical exenterative surgery.