Surgical treatment of the elderly patient with gynecologic cancer

One hundred and one patients with gynecologic oncologic disease who were 70 years of age or more underwent 169 surgical procedures during an eight year period. The rate of major morbidity was 22.0 per cent, and the operative mortality rate was 1.3 per cent. The one year survival rate was 86 per cent. We were unable to predict morbidity or mortality based on age, past history, American Society of Anesthesiologists class, preoperative laboratory studies or type of operation. When the group of elderly patients was compared with a control group of patients with cancer who were 60 years of age or less, there was a significantly higher rate of major morbidity in the elderly (22 versus 9 per cent), but more one year survivors (86 versus 74 per cent). We conclude that age alone should not be a deterrent to surgical management of gynecologic malignant disease. With careful perioperative management and attention to the unique problems of the elderly, acceptable surgical rates can be achieved.