Department of Obstetrics and Gynecology, University of Alabama at Birmingham, AL 35233, USA.
Int J Gynecol Cancer. 2013 Jul;23(6):1006-9. doi: 10.1097/IGC.0b013e3182980fac.
The decision to choose surgical cytoreduction in patients with newly diagnosed ovarian cancer may be influenced by their age. We compared perioperative morbidity and mortality of octogenarians compared with younger patients undergoing surgical cytoreduction.
A retrospective chart review identified patients who underwent primary surgical cytoreduction for ovarian cancer between January 2005 and December 2009. Patients were divided into 2 cohorts: younger than 80 years and 80 years or older (octogenarian). Patient demographics, surgical procedures, 30-day readmission, length of stay, 30-day mortality rates, and chemotherapy administration were examined. Student t test and χ test were used to evaluate statistical significance.
Three hundred eighty-four patients who underwent surgical cytoreduction for ovarian cancer were identified. Three hundred fifty-two patients (91.7%) were younger than 80 years, whereas 32 patients (8.3%) were 80 years or older. Two hundred thirty-six women (67.0%) in the younger cohort had optimal cytoreduction (<1 cm) compared with 17 women (53.1%) in the older cohort (P = 0.12). Thirty-day readmission rates and postoperative complications were similar. More patients in the older cohort required preoperative admission for medical clearance (P < 0.01). Mean length of stay was significantly longer in the older cohort (10.0 vs 7.5; P = 0.02). The number of patients who received adjuvant chemotherapy was significantly lower in the older cohort (71.9% vs 93.8%; P < 0.01). The 30-day mortality rate was significantly higher in the older cohort (18.8% vs 4.0%; P < 0.01).
Although octogenarians with ovarian cancer have similar surgical complication rates as their younger counterparts, they require more medical clearance and have a longer hospital stay. Older patients are less likely to undergo chemotherapy and have a higher 30-day mortality rate than are younger patients.
在新诊断的卵巢癌患者中选择手术细胞减灭术的决策可能会受到其年龄的影响。我们比较了 80 岁以上和年轻患者接受手术细胞减灭术的围手术期发病率和死亡率。
回顾性图表审查确定了 2005 年 1 月至 2009 年 12 月期间接受原发性手术细胞减灭术治疗卵巢癌的患者。患者分为两组：年龄小于 80 岁和 80 岁或以上（80 岁以上）。检查患者人口统计学、手术程序、30 天再入院、住院时间、30 天死亡率和化疗管理情况。使用学生 t 检验和 χ 检验评估统计学意义。
确定了 384 名接受手术细胞减灭术治疗卵巢癌的患者。352 名患者（91.7%）年龄小于 80 岁，32 名患者（8.3%）年龄为 80 岁或以上。年轻组中有 236 名女性（67.0%）获得了理想的细胞减灭术（<1 cm），而老年组中有 17 名女性（53.1%）（P=0.12）。30 天再入院率和术后并发症相似。老年组中有更多的患者需要入院进行术前医疗检查（P<0.01）。老年组的平均住院时间明显更长（10.0 比 7.5；P=0.02）。老年组接受辅助化疗的患者人数明显较少（71.9%比 93.8%；P<0.01）。老年组的 30 天死亡率明显更高（18.8%比 4.0%；P<0.01）。
尽管患有卵巢癌的 80 岁以上患者的手术并发症发生率与年轻患者相似，但他们需要更多的医疗检查，并且住院时间更长。与年轻患者相比，老年患者接受化疗的可能性较低，30 天死亡率较高。
