Geriatric patients with gynecological malignancy: our surgical experience

Objectives: Global improvements in health care and an increased life expectancy have led to a significant increase in the geriatric population. Because the prevalence of comorbidity increases with age, when confronted with a geriatric patient, there is common tendency to avoid radical surgery. However, new developments in the field of anesthesiology, peri-operative care and surgical techniques have modified the scenario. The aim of our study is to analyze the distribution of gynecological malignancy among geriatrics, to evaluate the surgical feasibility and outcome in terms of operative morbidity. Methods: In a retrospective analysis, we evaluated tumor site, comorbidities, details of surgery, intra operative and post operative morbidity and mortality for women (≥ 65 years) operated on for gynecological malignancies at the department of Gynecologic Oncology, Gujarat Cancer & Research Institute from January 2008 to December 2011.Results: In 153 patients, 7 patient were operated for cervical, 85 patients for ovarian, 33 patients for endometrial and 28 patients for vulvar cancer. Co-morbid illness was found in 58.82% patients. Overall intraoperative and postoperative morbidity was encountered in 1.3% and 10.46% patients respectively, Conclusion: Our study suggests that radical surgery is reasonably feasible and well tolerated by geriatric patients with an acceptable incidence of complications, in specialised units. The presence of routinely encountered co-morbid conditions should not deter us from providing curative treatment in this age group, but aggressive perioperative monitoring should be used for these patients. Improving clinical outcome and preserving quality of life both must be priorities even in geriatric cancer patients.