Pelvic exenteration

Impact of age on surgical and oncologic outcomes

Marilyn Huang, David A. Iglesias, Shannon N. Westin, Bryan Fellman, Diana Urbauer, Kathleen M. Schmeler, Michael Frumovitz, Pedro T. Ramirez, Pamela T. Soliman

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective To evaluate whether preoperative age impacts surgical outcomes, complication rates, and/or recurrence in women undergoing pelvic exenteration. Methods All women who underwent a pelvic exenteration for any gynecologic indication at our institution from 1993 to 2010 were included. Women were stratified into groups based on age in years (young: ≤ 50, middle: 51-64, and senior: ≥ 65). Baseline characteristics, surgical outcomes, early (<60 days) and late (≥ 60 days) postoperative complications, and recurrence/survival outcomes were ascertained. Fisher's exact test or Kruskal-Wallis test was performed. Kaplan-Meier survival curves were compared. Results 161 patients were included (58 young, 62 in the middle, and 41 senior). Women in the young group predominately had a diagnosis of cervical cancer (82.8%) while women in the senior group primarily had a diagnosis of vulvar or vaginal cancer (70.7%). Senior women were also more likely to have hypertension (p <0.0001) and pulmonary disease (p = 0.040). Operative time was significantly shorter for women in the senior group (8.5 h) compared with the middle (9.5 h) and young group (10.1 h) (p = 0.0089). There were no significant differences in early or late complications when stratified by age. The overall survival did not differ between age groups (p = 0.3760). Conclusion Although hypertension and pulmonary disease were more frequent in the senior age group, duration of surgery, blood loss, length of hospital stay and complication rates did not increase with age. Advanced chronological age should not be considered a contraindication to a potentially curative surgical procedure.

Original languageEnglish (US)
Pages (from-to)114-118
Number of pages5
JournalGynecologic Oncology
Volume132
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Fingerprint

Pelvic Exenteration
Lung Diseases
Length of Stay
Age Groups
Vaginal Neoplasms
Vulvar Neoplasms
Hypertension
Recurrence
Survival
Kaplan-Meier Estimate
Operative Time
Uterine Cervical Neoplasms

Keywords

  • Age
  • Gynecologic cancer
  • Pelvic exenteration

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Huang, M., Iglesias, D. A., Westin, S. N., Fellman, B., Urbauer, D., Schmeler, K. M., ... Soliman, P. T. (2014). Pelvic exenteration: Impact of age on surgical and oncologic outcomes. Gynecologic Oncology, 132(1), 114-118. https://doi.org/10.1016/j.ygyno.2013.11.014

Pelvic exenteration : Impact of age on surgical and oncologic outcomes. / Huang, Marilyn; Iglesias, David A.; Westin, Shannon N.; Fellman, Bryan; Urbauer, Diana; Schmeler, Kathleen M.; Frumovitz, Michael; Ramirez, Pedro T.; Soliman, Pamela T.

In: Gynecologic Oncology, Vol. 132, No. 1, 01.2014, p. 114-118.

Research output: Contribution to journalArticle

Huang, M, Iglesias, DA, Westin, SN, Fellman, B, Urbauer, D, Schmeler, KM, Frumovitz, M, Ramirez, PT & Soliman, PT 2014, 'Pelvic exenteration: Impact of age on surgical and oncologic outcomes', Gynecologic Oncology, vol. 132, no. 1, pp. 114-118. https://doi.org/10.1016/j.ygyno.2013.11.014
Huang M, Iglesias DA, Westin SN, Fellman B, Urbauer D, Schmeler KM et al. Pelvic exenteration: Impact of age on surgical and oncologic outcomes. Gynecologic Oncology. 2014 Jan;132(1):114-118. https://doi.org/10.1016/j.ygyno.2013.11.014
Huang, Marilyn ; Iglesias, David A. ; Westin, Shannon N. ; Fellman, Bryan ; Urbauer, Diana ; Schmeler, Kathleen M. ; Frumovitz, Michael ; Ramirez, Pedro T. ; Soliman, Pamela T. / Pelvic exenteration : Impact of age on surgical and oncologic outcomes. In: Gynecologic Oncology. 2014 ; Vol. 132, No. 1. pp. 114-118.
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abstract = "Objective To evaluate whether preoperative age impacts surgical outcomes, complication rates, and/or recurrence in women undergoing pelvic exenteration. Methods All women who underwent a pelvic exenteration for any gynecologic indication at our institution from 1993 to 2010 were included. Women were stratified into groups based on age in years (young: ≤ 50, middle: 51-64, and senior: ≥ 65). Baseline characteristics, surgical outcomes, early (<60 days) and late (≥ 60 days) postoperative complications, and recurrence/survival outcomes were ascertained. Fisher's exact test or Kruskal-Wallis test was performed. Kaplan-Meier survival curves were compared. Results 161 patients were included (58 young, 62 in the middle, and 41 senior). Women in the young group predominately had a diagnosis of cervical cancer (82.8{\%}) while women in the senior group primarily had a diagnosis of vulvar or vaginal cancer (70.7{\%}). Senior women were also more likely to have hypertension (p <0.0001) and pulmonary disease (p = 0.040). Operative time was significantly shorter for women in the senior group (8.5 h) compared with the middle (9.5 h) and young group (10.1 h) (p = 0.0089). There were no significant differences in early or late complications when stratified by age. The overall survival did not differ between age groups (p = 0.3760). Conclusion Although hypertension and pulmonary disease were more frequent in the senior age group, duration of surgery, blood loss, length of hospital stay and complication rates did not increase with age. Advanced chronological age should not be considered a contraindication to a potentially curative surgical procedure.",
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AU - Urbauer, Diana

AU - Schmeler, Kathleen M.

AU - Frumovitz, Michael

AU - Ramirez, Pedro T.

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N2 - Objective To evaluate whether preoperative age impacts surgical outcomes, complication rates, and/or recurrence in women undergoing pelvic exenteration. Methods All women who underwent a pelvic exenteration for any gynecologic indication at our institution from 1993 to 2010 were included. Women were stratified into groups based on age in years (young: ≤ 50, middle: 51-64, and senior: ≥ 65). Baseline characteristics, surgical outcomes, early (<60 days) and late (≥ 60 days) postoperative complications, and recurrence/survival outcomes were ascertained. Fisher's exact test or Kruskal-Wallis test was performed. Kaplan-Meier survival curves were compared. Results 161 patients were included (58 young, 62 in the middle, and 41 senior). Women in the young group predominately had a diagnosis of cervical cancer (82.8%) while women in the senior group primarily had a diagnosis of vulvar or vaginal cancer (70.7%). Senior women were also more likely to have hypertension (p <0.0001) and pulmonary disease (p = 0.040). Operative time was significantly shorter for women in the senior group (8.5 h) compared with the middle (9.5 h) and young group (10.1 h) (p = 0.0089). There were no significant differences in early or late complications when stratified by age. The overall survival did not differ between age groups (p = 0.3760). Conclusion Although hypertension and pulmonary disease were more frequent in the senior age group, duration of surgery, blood loss, length of hospital stay and complication rates did not increase with age. Advanced chronological age should not be considered a contraindication to a potentially curative surgical procedure.

AB - Objective To evaluate whether preoperative age impacts surgical outcomes, complication rates, and/or recurrence in women undergoing pelvic exenteration. Methods All women who underwent a pelvic exenteration for any gynecologic indication at our institution from 1993 to 2010 were included. Women were stratified into groups based on age in years (young: ≤ 50, middle: 51-64, and senior: ≥ 65). Baseline characteristics, surgical outcomes, early (<60 days) and late (≥ 60 days) postoperative complications, and recurrence/survival outcomes were ascertained. Fisher's exact test or Kruskal-Wallis test was performed. Kaplan-Meier survival curves were compared. Results 161 patients were included (58 young, 62 in the middle, and 41 senior). Women in the young group predominately had a diagnosis of cervical cancer (82.8%) while women in the senior group primarily had a diagnosis of vulvar or vaginal cancer (70.7%). Senior women were also more likely to have hypertension (p <0.0001) and pulmonary disease (p = 0.040). Operative time was significantly shorter for women in the senior group (8.5 h) compared with the middle (9.5 h) and young group (10.1 h) (p = 0.0089). There were no significant differences in early or late complications when stratified by age. The overall survival did not differ between age groups (p = 0.3760). Conclusion Although hypertension and pulmonary disease were more frequent in the senior age group, duration of surgery, blood loss, length of hospital stay and complication rates did not increase with age. Advanced chronological age should not be considered a contraindication to a potentially curative surgical procedure.

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