Ovarian cancer cytoreductive surgery in the elderly

Patient selection for cytoreductive surgery is a critical clinical assessment that defines the early management of ovarian cancer, and standardized patient-selection criteria for debulking surgery are lacking. The term "elderly" has been variably defined in the ovarian cancer debulking literature as being older than age 60, 70, or 80+ years of age. Multiple studies indicate the feasibility and acceptable complication rates for debulking surgery among women > or =70 years of age. These studies demonstrate improved survival among optimally debulked patients. There are limited data specifically addressing the advanced elderly, age > or =80; however, selected patients appear to be appropriate candidates. Further dedicated study addressing the patient selection for debulking surgery and treatment outcomes among elderly ovarian cancer patients is needed. In this article, outcome studies addressing the application of major gynecologic surgery, including cytoreductive surgery, in the elderly population are reviewed, and current areas of clinical investigation are highlighted.